JP4184833B2 - 可撓性尿管腎盂用内視鏡 - Google Patents
可撓性尿管腎盂用内視鏡 Download PDFInfo
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- JP4184833B2 JP4184833B2 JP2003055422A JP2003055422A JP4184833B2 JP 4184833 B2 JP4184833 B2 JP 4184833B2 JP 2003055422 A JP2003055422 A JP 2003055422A JP 2003055422 A JP2003055422 A JP 2003055422A JP 4184833 B2 JP4184833 B2 JP 4184833B2
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- G—PHYSICS
- G02—OPTICS
- G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
- G02B23/00—Telescopes, e.g. binoculars; Periscopes; Instruments for viewing the inside of hollow bodies; Viewfinders; Optical aiming or sighting devices
- G02B23/24—Instruments or systems for viewing the inside of hollow bodies, e.g. fibrescopes
- G02B23/2476—Non-optical details, e.g. housings, mountings, supports
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00064—Constructional details of the endoscope body
- A61B1/00071—Insertion part of the endoscope body
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/005—Flexible endoscopes
- A61B1/0051—Flexible endoscopes with controlled bending of insertion part
- A61B1/0055—Constructional details of insertion parts, e.g. vertebral elements
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- G—PHYSICS
- G02—OPTICS
- G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
- G02B23/00—Telescopes, e.g. binoculars; Periscopes; Instruments for viewing the inside of hollow bodies; Viewfinders; Optical aiming or sighting devices
- G02B23/24—Instruments or systems for viewing the inside of hollow bodies, e.g. fibrescopes
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/005—Flexible endoscopes
- A61B1/0051—Flexible endoscopes with controlled bending of insertion part
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Description
【発明の属する技術分野】
本発明は医療工具、特に内視鏡、可撓性尿管腎盂用検器に関する。
【0002】
【従来の技術】
米国特許第4873965号明細書は、間接で接続された二つの長さ部分を備えた可撓性内視鏡を開示している。英国特許出願第2130885号は内視鏡用可撓性先端部分を開示している。先端部分は、細長い部材即ち針状部によって接続される脊柱部を有するプラスチック材料からなっている。米国特許第5938588号は、超弾性合金材料から固体チューブとして作られるワイヤー鞘部を有する内視鏡を開示している。内視鏡は当該技術分野において公知であって、能動偏向部分と受動偏向部分とを備えている。
【0003】
【課題を解決するための手段】
本発明の一つの態様によれば、制御用部分と該制御用部分から延びるシャフトとを有する可撓性可撓性尿管腎盂用検器において、前記シャフトは第二の能動偏向部分に直列に連結された第一の能動偏向部分を備えた前方端部を含んでおり、前記制御用部分は前記第一および第二の能動偏向部分を独立して偏向させられるようになっており、それにより、下葉の腎杯に到達するために前記シャフトの前記前方端部が患者の腎臓の組織に対して受動的に偏向することを必要とすることなしに、可撓性尿管腎盂用検器の先端が前記腎臓の前記下葉の前記腎杯内に配置されるように前記第一および第二の能動偏向部分が偏向するようにした可撓性尿管腎盂用検器が提供される。
【0004】
本発明の他の態様によれば、制御用部分と、前記制御用部分から延びるシャフトとを含み、該シャフトは直列に連結された二つの超弾性管状フレーム部材を備えた前方端部を有しており、前記フレーム部材のうちの第一のフレーム部材は曲率半径が約9mmから約12mmで第一の方向に関して約155°から約190°で偏向するようになっている第一の能動偏向部分を形成し、前記フレーム部材のうちの第二のフレーム部材は曲率半径が約9.5mmから約13mmで前記第一の方向とほぼ同一方向に関して約125°から約165°で偏向するようになっている第二の能動偏向部分を形成する可撓性尿管腎盂用検器が提供される。
【0005】
本発明の一つの方法によれば、可撓性尿管腎盂用検器の先端チップを腎臓内の下葉の腎杯内に配置する配置方法において、前記可撓性尿管腎盂用検器のシャフトの前方端部の第一の能動偏向部分を湾曲させ、前記シャフトの前記前方端部の第二の能動偏向部分を湾曲させ、該第二の能動偏向部分は前記第一の能動偏向部分の後方に位置しており、それにより、前記第一および第二の能動偏向部分が独立して制御可能に偏向できて、前記前方端部が前記患者の腎臓組織に対して受動的に偏向することを必要とすることなしに、前記先端チップを前記下葉の前記腎杯内に配置するようにした配置方法が提供される。
【0006】
【発明の実施の形態】
添付図面を参照することによって本発明の前述した特徴および他の特徴を以下に説明する。
図1を参照すると、本発明の特徴を組み入れた内視鏡10の側面図が示されている。本発明は添付図面に示される実施形態を参照して説明されるが、本発明を他の多数の実施形態において実施可能であることを理解すべきである。本発明の特徴を可撓性で偏向可能な種々の異なる内視鏡において実施することができる。さらに他の適切な寸法、形状または形式の要素または材料を採用することができる。
【0007】
本実施形態において内視鏡10は可撓性の尿管腎孟用内視鏡(ureteropyeloscope)である。内視鏡10は概ねハンドル12と、ハンドル12に連結された可撓性シャフト14と、能動偏向特性を備えたシャフトの前方端部18とを含んでいる。
【0008】
ハンドル12は前方端部18の能動偏向特性を制御する制御システムの一部である。制御システムは概ねハンドル12と、二つのアクチュエータ16、17と、ブレーキ・アクチュエータ22と、三つの制御用ワイヤ24、25、26とを含んでいる(図6を参照されたい)。しかしながら、他の実施形態においては制御システムが追加の構成要素または別の構成要素を含んでいても良い。三つのアクチュエータ16、17、22はハンドル12に移動可能に取り付けられている。制御用ワイヤ24、25、26の基端は二つの制御用アクチュエータ16、17に連結されている。ブレーキ・アクチュエータ22は第二の制御用アクチュエータ17を固定位置でロックするためのブレーキ機構部に連結されている。しかしながら、他の実施形態においては他の適切な形式のブレーキまたはロック機構部を設けることもできる。他の実施形態の一つにおいては、内視鏡は制御アクチュエータ用ブレーキを含んでなくてもよい。図示される実施形態においては、第一の制御用アクチュエータ16はブレーキを含んでいない。
【0009】
ハンドル12は光源ポスト28と、アイピース30と、作業用工具/灌注用入口部32とを含んでいる。しかしながら、他の実施形態においてはハンドル12が追加の構成要素または別の構成要素を含んでいても良い。工具は、光源ポスト28と先端20との間において可撓性シャフト14を通って延びる照明用光ファイバのバンドルを含んでいる。光ファイバからのイメージ・バンドルはアイピース30と先端20との間において可撓性シャフト14を通って延びる。作業用チャネルが作業用工具入口部32と先端20との間において可撓性シャフト14を通って延びている。
【0010】
前方端部18の後方の可撓性シャフト14はあらゆる形式の可撓性シャフト、例えば米国特許出願第09/547686号に開示されるシャフトを採用でき、この公報全体を参照することによって本願明細書の記載に代える。前方端部18は第一の能動偏向部分34と第二の能動偏向部分36とを含んでいる。図2を参照すると、前方端部18が配置される腎臓Kの断面図が示されている。二つの能動偏向部分34、36は、内視鏡の先端20が下葉または下極(lower pole)LPにおける腎臓の腎杯LPC内に突出できるようになっている。さらに詳細には、二つの能動偏向部分34、36は、前方端部18が患者の腎臓組織から受動的に偏向することなしに、先端20が下葉LP内の腎杯LPC内に突出できるようになっている。前方端部18は受動偏向部分を含んでいない。その代わりに、前方端部18は前述した二つの能動偏向部分を含んでいる。
【0011】
図3(a)から図3(d)、図4(a)から図4(b)、図5(a)から図5(b)、および図6を参照して前方端部18の構成要素を説明する。前方端部18は概ね先端部材38と、第一のフレーム部材40と、第二のフレーム部材42と、取付具44とを含んでいる。前方端部18は封止ジョイント47においてカバー46に取り付けられたエラストマ・カバー45もさらに含んでおり、カバー46は可撓性シャフト14の全長さ部分に延びている。先端部材38は第一のフレーム部材40の前方端部に連結されている。第二の制御用ワイヤ25と第三の制御用ワイヤ26との前方端部は先端部材38に固定されている。
【0012】
第一のフレーム部材40は概ね単一の一体部材からなる略管状部材である。しかしながら、他の実施形態においては第一のフレーム部材40は一つより多い管、例えば直列に接続された複数の管から形成されていてもよく、また追加の部材を含んでいても良い。第一のフレーム部材40は形状記憶合金材料、例えばチネル(Tinel)またはニチノールから形成されるのが好ましい。しかしながら、他の適切な形式の形状記憶合金を採用することもできる。形状記憶合金は、材料歪みが4%に達するかまたは通常の材料において塑性変形を生じさせる0.4%の典型的な降伏応力よりも大きいオーダの大きさに接近する場合でさえ、材料特性により示される超弾性特性によって偏向すると共に固有位置または所定位置まで弾性的に復帰させるために使用される。従って、用語「超弾性材料(superelastic alloy)」はこの形式の材料を示すのに使用される。
【0013】
第一のフレーム部材40は前方開放端48と後方開放端50とを備えた中心チャネル49と、フレーム部材40内部のスロット52とを有している。第一のフレーム部材40は第一の能動偏向部分34のためのフレームを形成する。図示される実施形態においてスロット52は対向する二つの方向に関して第一のフレーム部材40内に延びている。しかしながら、他の実施形態においてはスロット52が二つより多いかまたはこれより少ない方向に関して第一のフレーム部材40内に延びていてもよい。スロット52は第一のフレーム部材40の長さの大部分に沿って第一のフレーム部材40内に延びていて、直径の半分よりも長い距離まで第一のフレーム部材40内に延びている。しかしながら、他の実施形態においてはスロット52は他の適切な形式の配列または形状で形成されていてもよい。同様な超弾性フレーム部材は米国特許出願第09/427164号に開示されており、その全体を参照することによって本願明細書の記載に代える。
【0014】
第一のフレーム部材40の後方端部50は取付具44に固定されている。取付具44は適切な材料、例えば金属からなる単一部材より形成されている。しかしながら、他の実施形態においては取付具44は一つよりも多い部材から形成されていてもよく、またフレーム部材の一方または両方に組み入れられても良く、適切な形式の他の材料から形成されていてもよい。取付具44は概ね中心部分54と二つの端部部分56、58とを含んでいる。第一のフレーム部材40の後方端部50は第一の端部部分56の外部に固定されている。
【0015】
中心部分54は取付具44周りに隆起した管状リングを形成している。この隆起した管状リングは二つのフレーム部材の端部50、70のための停止面を形成している。他の実施形態においては、フレーム部材を取付具上に位置決めするための他の適切な形式の位置決めシステムを設けても良い。
【0016】
取付具44の内部は概ね二つの貫通孔60、62と、第一の制御用ケーブル24の端部を取り付けるための取付部分64とを含んでいる。二つの貫通孔60、62は第二および第三の制御用ケーブル25、26がこれら貫通孔内部を通って摺動できるように寸法決めされて形成されている。取付部分64はアパーチャ66を含んでいる。アパーチャ66はケーブル24の前方端部24aを受容するように寸法決めされて形成されており、それにより、前方端部24aは取付部分に固定されて取り付けられるようになる。しかしながら、他の実施形態においては他の適切な手段を採用してケーブル24の前方端部を取付具44に取り付けることもできる。さらに、他の実施形態においては取付具44が取付具に固定可能に取り付けられる一つよりも多くの制御用ケーブルを備えるようにしても良い。さらに、他の実施形態においては取付具44は取付具44を通過する二つより多いかまたはこれより少ない制御用ケーブルを有するようにしてもよい。
【0017】
第二のフレーム部材42は概ね単一部材の略管状部材を含んでいる。しかしながら、他の実施形態においては第二のフレーム部材42は一つよりも多くの管、例えば直列に連結された複数の管から形成されていてもよく、追加の部材を含んでいても良い。第二のフレーム部材42は、米国特許出願第09/427164号に開示されるのと同様に、可撓性シャフト14の長さ部分に沿って延びる部材の前方部分から形成されうる。第二のフレーム部材42は、前述した第一のフレーム部材40の場合と同様に形状記憶合金材料から形成されるのが好ましい。
【0018】
第二のフレーム部材42は前方開放端70と後方開放端72とを備えた中心チャネル68と、フレーム部材42内部のスロット74とを有している。第二のフレーム部材42は第二の能動偏向部分36のためのフレームを形成する。図示される実施形態においてスロット74は一つの方向のみに関して第二のフレーム部材42内に延びている。しかしながら、他の実施形態においてはスロット74が一つ以上の方向に関して第二のフレーム部材42内に延びていてもよい。スロット74は第二のフレーム部材42の長さの大部分に沿って第二のフレーム部材42まで延びていて、直径の約四分の三の距離まで第二のフレーム部材42内に延びている。しかしながら、他の実施形態においてはスロット74は他の適切な形式の配列または形状もしくはフレーム部材の横方向側部への延びの深さで形成されていてもよい。
【0019】
図示される実施形態においては、第二のフレーム部材42は図5(a)に示されるような所定の湾曲定位置を含んでいる。しかしながら、他の実施形態においては第二のフレーム部材42は図4(a)に示されるような第一のフレーム部材40の直線状定位置のような他の適切な形状の定位置を含んでも良い。他の実施形態においては、第一のフレーム部材40が湾曲した所定の定位置を含んでも良い。第二のフレーム部材42の前方端部70は取付具44の後方部分58に固定されている。第二のフレーム部材42の後方端部72は前方端部18の後方に位置するシャフト14のフレームに固定されている。
【0020】
他の実施形態においては第一のフレーム部材40および/または第二のフレーム部材42は他の適切な材料および/または部材から形成されうる。例えばこれら部材が可撓性部材により連結された金属製リング(例えば超弾性材料または他の可撓性材料からなるロッド)から形成されるか、またはこれら部材が互いに回動可能に連結された金属製リングを単に含んでいても良い。本発明の特徴は、超弾性材料のみからなる二つの管状フレーム部材のみを使用することに制限されない。例えば他の実施形態の一つの形式を図8に示す。この他の実施形態においては、第一および第二の能動偏向部分はリング部材80を含んでいる。リング部材80はジョイント82において互いに直列に回動可能に連結されている。第一の制御用ワイヤ24は一つのリング部材84に連結された先端を有している。他の制御用ワイヤ25、26はリング部材を通過している。金属製リングはステンレス鋼から形成されうる。可撓性の偏向可能内視鏡用シャフトの異なる形式の構成は当該技術分野において知られており、これら構成を採用または変更して本発明を実施することもできる。
【0021】
図示される実施形態においては、第二のフレーム部材42の横方向側部76は取付具44の取付部分64に整列されており、これら横方向側部76内にスロット74が形成されている。アクチュエータ16によって所定位置に設定されたときに第一の制御用ケーブル24は取付具44にテンションを加え、それにより、第二のフレーム部材42がほぼ直線状形状をなすように維持される。第一の制御用ケーブル24がアクチュエータ16によって後方に引かれるときには、第二のフレーム部材42は横方向側部76に沿って内方に屈曲するようになる。第一の制御用ケーブル24が解放されるときには、湾曲した所定形状の第二のフレーム部材42からの内部応力によって、第二の能動偏向部分36が直線状定位置まで戻る。
【0022】
ここで図7を参照して本発明により形成される特定の特徴を説明する。図7は三つの可能な位置における前方端部18を示している。第一の位置Aは直線形状をなす前方端部18を示している。前方端部18は長さL1を有している。好ましい実施形態においては長さL1は約7cmである。他の実施形態においては長さL1は他の適切な長さをとりうる。第一の能動偏向部分34の長さは約3.6cmであるのが好ましい。第二の能動偏向部分36は約2.8cmであるのが好ましい。しかしながら、他の実施形態においては第一および第二の能動偏向部分の長さは他の適切な長さをとりうる。前方端部18は前方端部部材38と取付具44とによってそれぞれ形成される二つの非湾曲部分33、35も含んでいる。
【0023】
位置Bおよび位置Cは二つの異なる最大偏向位置における前方端部18を示している。第二の能動偏向部分36は一方向にのみ湾曲可能であるので第二の能動偏向部分36はこれら二つの偏向位置B、Cの両方に関して同一の湾曲形状部36’である。第二の能動偏向部分36の湾曲偏向部は最大曲率が約125°から165°であって、曲率半径R2が約9.5mmから13mmである。好ましい実施形態においては、最大曲率は約135°で曲率半径R2が約10.6mmである。しかしながら、他の実施形態においては他の適切な最大曲率または曲率半径を採用できる。
【0024】
図示される実施形態において第一の能動偏向部分は二方向に偏向可能であり、それにより、第一の能動偏向部分は形状B、Cのうちの一方のように偏向されうる。第一の偏向形状Bにおいては第一の能動偏向部分34は最大曲率が約155°から約190°で曲率半径R1’が約9mmから約12mmの湾曲形状34’である。好ましい実施形態においては、最大曲率が約180°で曲率半径R1’が約10.6mmである。しかしながら、他の実施形態においては他の適切な最大曲率または曲率半径を採用できる。
【0025】
第二の偏向形状Cにおいては、能動偏向部分34は湾曲形状部34’’である。湾曲形状部34’’は最大曲率が約155°から約190°であり、曲率半径R1’’が約9mmから約12mmである。好ましい実施形態においては、最大曲率は約175°で曲率半径R1’’は約11.3mmである。しかしながら、他の実施形態においては他の適切な最大曲率または曲率半径を採用できる。工具の構成のために、これら偏向部の全ては同一の平面に限定される。しかしながら、他の実施形態においては工具の前方端部が一つよりも多い平面において偏向するようになっている。
【0026】
図示される実施形態においては第一の制御用ワイヤ24は第二の制御用ワイヤ25と第三の制御用ワイヤ26とを含む平面からわずかにずれている。それゆえ、第二の能動偏向部分36は、第一の能動偏向部分34の偏向面からわずかにずれた平面において偏向する。これら二つの平面の差は45°よりも小さく、0°に近いこと、例えば約5°から約10°のみであることが好ましい。他の実施形態においては二つの能動偏向部分が同一の平面における偏向作用に制限されうる。
【0027】
図1、図2および図7を参照すると、内視鏡10の制御部分が第一および第二の能動偏向部分を独立して偏向させるようになっている。第一および第二の能動偏向部分は、シャフトの前方端部18が腎臓の組織に対して受動的に偏向して腎杯に到達することなしに、可撓性尿管腎盂用検器の先端20が腎臓Kの下葉LPの腎杯LPC内に配置されるように偏向するようになっている。
【0028】
通常の形状および寸法の腎臓に関しては、能動偏向部分と受動偏向部分とを備えた前方端部を有する可撓性尿管腎盂用検器は腎臓の下葉の腎杯に到達できる。しかしながら、異常に大きいかまたは奇形の腎臓の場合には、シャフトの先端を腎臓内の操作可能位置に配置するために、能動偏向部分を前方端部に有する可撓性尿管腎盂用検器は能動偏向部分を有効に使用することはできない。能動偏向作用が生ずる場所が下葉の腎杯に対して上方であるので、従来技術の可撓性尿管腎盂用検器の先端を十分下方に単純に下げることができなかった。本発明はこの問題を克服するものである。可撓性尿管腎盂用検器の前方端部に独立して偏向可能な二つの能動偏向部分を設けることによって、腎臓の寸法および形状に関わらず、可撓性尿管腎盂用検器の前方端部を先端20を腎臓の下葉の腎杯内に配置することができる。
【0029】
先端20を所望の位置に適切に位置決めするために、可撓性尿管腎盂用検器10は能動偏向部を腎臓の組織に対して使用することに依存することはない。可撓性尿管腎盂用検器10の前方端部を操作するために(尿管Uから)腎臓内部の下葉における腎杯内までの空間または実際の所有場所および曲がった小半径の総計は極めて限定される。二つの別個の形状記憶合金製フレーム部材40、42を使用することによって、本発明は前方端部18をこの制限された空間および鋭角湾曲経路環境において使用することができる。形状記憶合金製フレーム部材40、42の超弾性特性によって、フレーム部材をこの限定された空間および鋭角湾曲経路環境において偏向させられると共に、これらフレーム部材を定位置まで戻すことができる。超弾性特性の形状記憶合金製フレーム部材に結合された二つの能動偏向部分34、36を独立して偏向させられることによって、フレーム部材をこの限定された空間および鋭角湾曲経路環境を通る通路に通過させられる。単一の能動偏向部分のみが提供される場合には、下葉内の腎杯に到達するよう適切に操作するためには長さが長すぎる。そのような単一の能動偏向部分はいまだ尿管U内に存在し、従って、腎臓K自体によって適切に操作されるのが妨げられて端部部分を整形するのが妨げられる。それにより、先端が下葉の腎杯内の所望の位置に到達するようになる。従って、このことは、内視鏡10内の前方端部18が二つの独立した偏向可能能動偏向部分を有することが原因である。
【0030】
第二の能動偏向部分36の前に第一の能動偏向部分34を偏向させることができ、第二の能動偏向部分36が尿管Uから出たときに第二の能動偏向部分36を偏向させられる。能動偏向部分34、36が尿管Uを出るときにこれら能動偏向部分34、36を順次に偏向できることによって、受動偏向作用を使用することなしに、下葉の腎杯LPCにアクセスすることができる。本発明によって従来は利用不可能であった腎臓内の領域に到達することができる。
【0031】
本発明の他の実施形態においては、前方端部18は二つより多くの能動偏向部分を含んでもよい。第一の能動偏向部分34は同一平面において二方向に偏向可能であると記載した。他の実施形態においては、第一の能動偏向部分34は二方向よりも多いかまたはこれより少ない方向に偏向可能でありうる。そのような他の実施形態においては、制御システムが第一の能動偏向部分のために二つよりも多いかまたはこれより少ない制御用ケーブルを備えることができる。第二の能動偏向部分36は一方向に偏向可能であると記載した。他の実施形態においては第二の能動偏向部分36は略同一平面において一方向よりも多い方向に偏向可能でありうる。そのような他の実施形態においては、制御システムは第二の能動偏向部分のために一つよりも多い制御用ケーブルを備えることができる。
【0032】
図9を参照すると、他の実施形態のシャフトの前方端部が示されている。本実施形態においては、シャフトは先端の対物用ヘッド92と、第一の能動偏向部分94と、第二の能動偏向部分96と、非能動偏向部分98とを含んでいる。非能動偏向部分98は第一の能動偏向部分94と第二の能動偏向部分96との間に配置されるのが好ましい。非能動偏向部分98は米国特許出願第09/427164号に開示されるのと同様な受動偏向部分であるのが好ましい。しかしながら、他の実施形態においては、他の適切な形式の受動偏向部分を設けることもできる。この形式の構成については、シャフトの前方端部は要求される場合には部分98における患者の組織によって受動的に偏向されうる。しかしながら、能動偏向部分94、96における二つの別個の能動偏向作用のためにシャフトは組織から受動的に偏向されることが必要ではない。他の形式の他の実施形態においては、非能動偏向部分98は受動偏向部分ではない。
【0033】
前述の詳細説明は、本発明を表現しているだけであると理解されなければならない。種々の選択肢および変更態様は、本発明から逸脱することなく、当業者によって考え出され得る。したがって本発明は、全てのこの種の選択肢、変更態様および変形に関しては添付の請求の範囲の範囲内になるものとして、含むものである。
【図面の簡単な説明】
【図1】本発明の特徴を組み入れた内視鏡の側面図である。
【図2】図1に示した内視鏡の前方端部が配置されている腎臓の断面図である。
【図3】(a)図1に示される内視鏡の前方端部の二つのフレーム部材に結合するのに使用される取付具を示す図である。
(b)図1に示される内視鏡の前方端部の二つのフレーム部材に結合するのに使用される取付具を示す図である。
(c)図1に示される内視鏡の前方端部の二つのフレーム部材に結合するのに使用される取付具を示す図である。
(d)図1に示される内視鏡の前方端部の二つのフレーム部材に結合するのに使用される取付具を示す図である。
【図4】(a)図1に示される内視鏡の前方端部に配置されるフレーム部材のうちの第一のフレーム部材の側面図である。
(b)線4B−4Bに沿ってみた図4(a)に示される第一のフレーム部材の断面図である。
【図5】(a)図1に示される内視鏡の前方端部に配置されるフレーム部材の第二の形態の側面図である。
(b)線5B−5Bに沿ってみた図4(a)に示される第二のフレーム部材の断面図である。
【図6】図1に示される内視鏡のシャフトにおける或る構成要素の図4(a)から図5(b)に示される第一および第二のフレーム部材の間の接合部における部分断面図である。
【図7】図1に示される内視鏡の前方端部の可能な形状を示す略図である。
【図8】本発明の特徴を組み入れた第一および第二の能動偏向部分の互い違い形状からなるフレーム部分および制御ワイヤの一部を示す略図である。
【図9】本発明の特徴を組み入れた他の実施形態のシャフトの前方端部の側面図である。
【符号の説明】
10…内視鏡、可撓性尿管腎盂用検器
12…ハンドル
14…可撓性シャフト
16…アクチュエータ
17…アクチュエータ
18…前方端部
20…先端
22…ブレーキ・アクチュエータ
24…第一の制御用ケーブル
25…第二の制御用ケーブル
28…光源ポスト
30…アイピース
32…作業用工具/灌注用入口部
33…非湾曲部分
34…第一の能動偏向部分
36…第二の能動偏向部分
38…先端部材
40…第一のフレーム部材
42…第二のフレーム部材
44…取付具
45…エラストマ・カバー
46…カバー
47…封止ジョイント
48…前方開放端
49…中心チャネル
50…後方開放端
52…スロット
54…中心部分
64…取付部分
66…アパーチャ
68…中心チャネル
74…スロット
76…横方向側部
80…リング部材
82…ジョイント
Claims (12)
- 制御用部分と該制御用部分から延びるシャフトとを有する可撓性尿管腎盂用内視鏡において、
前記シャフトは第二の能動偏向部分に直列に連結された第一の能動偏向部分を備えた前方端部を含んでおり、前記制御用部分は前記第一および第二の能動偏向部分を独立して偏向させられるようになっており、それにより、下葉の腎杯に到達するために前記シャフトの前記前方端部が患者の腎臓の組織に対して受動的に偏向することを必要とすることなしに、可撓性尿管腎盂用内視鏡の先端が前記腎臓の前記下葉の前記腎杯内に配置されるように前記第一および第二の能動偏向部分が偏向するようにしており、
前記第一の能動偏向部分は第一のフレーム部材を含み、前記第二の能動偏向部分は第二のフレーム部材を含んでおり、
前記第一のフレーム部材は第一のスロットからなる配列体を内部に有し、前記第二のフレーム部材は第二の異なるスロットからなる配列体を内部に有する可撓性尿管腎盂用内視鏡。 - 前記第一のスロットからなる配列体は対向する二つの方向に関して前記第一のフレーム部材内に延びる請求項1に記載の可撓性尿管腎盂用内視鏡。
- 制御用部分と該制御用部分から延びるシャフトとを有する可撓性尿管腎盂用内視鏡において、
前記シャフトは第二の能動偏向部分に直列に連結された第一の能動偏向部分を備えた前方端部を含んでおり、前記制御用部分は前記第一および第二の能動偏向部分を独立して偏向させられるようになっており、それにより、下葉の腎杯に到達するために前記シャフトの前記前方端部が患者の腎臓の組織に対して受動的に偏向することを必要とすることなしに、可撓性尿管腎盂用内視鏡の先端が前記腎臓の前記下葉の前記腎杯内に配置されるように前記第一および第二の能動偏向部分が偏向するようにしており、
前記第一の能動偏向部分は、超弾性材料から形成される略円筒状の第一の形状記憶フレーム部材を含み、第二の能動偏向部分は超弾性材料から形成される略円筒状の第二の形状記憶フレーム部材を含んでおり、
前記第二のフレーム部材が湾曲した所定形状の定位置を有する可撓性尿管腎盂用内視鏡。 - 前記第二のフレーム部材は、前記制御用部分からの制御用ワイヤによるテンションによって直線状位置に維持される請求項3に記載の可撓性尿管腎盂用内視鏡。
- 制御用部分と、前記制御用部分から延びるシャフトとを含み、該シャフトは直列に連結された二つの超弾性管状フレーム部材を備えた前方端部を有しており、前記フレーム部材のうちの第一のフレーム部材は曲率半径が約9mmから約12mmで第一の方向に関して約155°から約190°で偏向するようになっている第一の能動偏向部分を形成し、前記フレーム部材のうちの第二のフレーム部材は曲率半径が約9.5mmから約13mmで前記第一の方向とほぼ同一方向に関して約125°から約165°で偏向するようになっている第二の能動偏向部分を形成しており、前記第一のフレーム部材が第一のスロットからなる配列体を内部に有し、前記第二のフレーム部材が異なる第二のスロットからなる配列体を内部に有する可撓性尿管腎盂用内視鏡。
- 前記第一の能動偏向部分は対向する第二の方向に関して約90°から約190°で偏向するようになっている請求項5に記載の可撓性尿管腎盂用内視鏡。
- 前記第一の能動偏向部分は曲率半径が約10.6mmで対向する少なくとも二つの方向うちの第一の方向に関して約185°で偏向するようになっていると共に、曲率半径が約11.3mmで対向する少なくとも二つの方向のうちの第二の方向に関して約175°で偏向するようになっている請求項5に記載の可撓性尿管腎盂用内視鏡。
- 前記第二の能動偏向部分は曲率半径が約10.6mmで約135°で偏向するようになっている請求項7に記載の可撓性尿管腎盂用内視鏡。
- 前記第一の能動偏向部分の長さが約3.6cmであり、前記第二の能動偏向部分の長さが約2.8cmである請求項8に記載の可撓性尿管腎盂用内視鏡。
- 前記第一のスロットからなる配列体のスロットが対向する二つの方向に関して前記第一のフレーム部材内に延びる請求項5に記載の可撓性尿管腎盂用内視鏡。
- 制御用部分と、前記制御用部分から延びるシャフトとを含み、該シャフトは直列に連結された二つの超弾性管状フレーム部材を備えた前方端部を有しており、前記フレーム部材のうちの第一のフレーム部材は曲率半径が約9mmから約12mmで第一の方向に関して約155°から約190°で偏向するようになっている第一の能動偏向部分を形成し、前記フレーム部材のうちの第二のフレーム部材は曲率半径が約9.5mmから約13mmで前記第一の方向とほぼ同一方向に関して約125°から約165°で偏向するようになっている第二の能動偏向部分を形成しており、
前記第二のフレーム部材が湾曲した所定形状の定位置を有する可撓性尿管腎盂用内視鏡。 - 前記第二のフレーム部材が前記制御用部分からの制御用ワイヤによるテンションによって直線状位置に維持される請求項11に記載の可撓性尿管腎盂用内視鏡。
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-
2002
- 2002-03-01 US US10/087,622 patent/US6780151B2/en not_active Ceased
-
2003
- 2003-02-28 DE DE10308902A patent/DE10308902B4/de not_active Expired - Fee Related
- 2003-03-03 JP JP2003055422A patent/JP4184833B2/ja not_active Expired - Lifetime
-
2005
- 2005-07-19 US US11/186,015 patent/USRE41475E1/en not_active Expired - Lifetime
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US11523924B2 (en) | 2015-04-28 | 2022-12-13 | Cook Medical Technologies Llc | Medical cannulae, delivery systems and methods |
Also Published As
Publication number | Publication date |
---|---|
JP2003250762A (ja) | 2003-09-09 |
US6780151B2 (en) | 2004-08-24 |
USRE41475E1 (en) | 2010-08-03 |
DE10308902A1 (de) | 2003-12-24 |
DE10308902B4 (de) | 2013-07-18 |
US20030023142A1 (en) | 2003-01-30 |
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