JP4349847B2 - Endoscopic magnetic anchor remote guidance system - Google Patents

Description

[0001]
【Technical field】
The present invention relates to an endoscopic magnetic anchor remote guidance system for use in excising a lesion under endoscopic observation.
[0002]
[Prior art and its problems]
Conventionally, when excising a lesion inside a human body in a normal operation, the distance between the lesion and the adjacent normal tissue is widened by lifting the lesion using a grasping forceps, and the lesion and the normal tissue are in that state. It is excised between. However, for example, in endoscopic mucosal resection (EMR), since only one endoscope can be inserted into the body, the lesion cannot be lifted, and the normal mucous membrane around the lesion cannot be lifted with an injection needle. Saline was injected to raise the lesion, and in that state, a high-frequency knife or snare was used to perform excision between the lesion and the normal mucosa.
[0003]
However, in such a conventional method, the lesioned part could not be lifted to a sufficient position, and thus a sufficient excision part at the boundary between the lesioned part and the normal tissue could not be secured.
In addition, when the lesioned part has a flat shape, it may not be possible to create an excised part.
[0004]
Further, during the excision work, the already excised lesioned part may fall on the normal tissue, thereby obstructing the field of view by the endoscope, particularly when the lesioned part is large. For this reason, the excised part cannot be seen, and in order to remove it blindly, the normal part is damaged and complications such as perforation occur, blood vessels are damaged and major bleeding occurs. Since it could not be confirmed and hemostasis could not be achieved, serious complications could occur, and a safer device was required.
[0005]
Therefore, in order to solve these problems, the present applicant is arranged outside the human body with a gripping member that grips a lesioned part inside a human organ, a magnetic anchor made of a magnetic body connected to the gripping member, and a magnetic anchor. A magnetic anchor guide device that generates a magnetic field and powers the magnetic anchor, and lifts the lesioned part gripped by the gripping member by powering the magnetic anchor by the magnetic field generated by the magnetic anchor guide device. A magnetic anchor remote guidance system is proposed and a patent application has been filed (Japanese Patent Application No. 2002-268239).
[0006]
OBJECT OF THE INVENTION
An object of the present invention is to remotely guide a magnetic anchor for an endoscope, which can quickly and easily excise a target part and can easily and reliably collect a magnetic anchor inserted into the object. To provide a system .
[0007]
Summary of the Invention
An endoscope magnetic anchor remote guidance system according to the present invention includes a gripping member capable of gripping a target portion inside a target, a magnetic anchor containing a magnetic material connected to the gripping member, and the outside of the target A magnetic anchor guiding device that is arranged and generates a magnetic field, and moves the magnetic anchor by a magnetic force generated by the magnetic field generated by the magnetic anchor guiding device, so that a target site gripped by the gripping member is predetermined. Endoscopic magnetic anchor remote guidance system for moving in the direction, wherein the magnetic anchor has no magnetic shielding property and can be ruptured by a needle-like member, and a magnetic material filled in the bag And a fluid.
[0008]
Specifically, the bag body can be made of, for example, a rubber material.
[0009]
Furthermore, it is preferable that the bag body ruptured by the needle-like member can be sucked and attached to the outlet portion of the suction channel of the endoscope.
[0010]
Furthermore, it is preferable that the magnetic fluid flowing out from the bag body ruptured by the needle-like member can be sucked and collected from the suction channel of the endoscope.
[0011]
Further, the bag body that has been ruptured by the needle-like member may be graspable by a grasping forceps that can be inserted into a forceps channel of an endoscope, and may be recoverable via the forceps channel.
[0012]
According to another aspect, an endoscopic magnetic anchor remote guidance system of the present invention includes a gripping member capable of gripping a target portion inside a target, and a magnetic anchor containing a magnetic material connected to the gripping member. A magnetic anchor guiding device arranged outside the object and generating a magnetic field, and the magnetic anchor is moved by the magnetic force generated by the magnetic anchor guiding device and gripped by the gripping member In the endoscopic magnetic anchor remote guidance system for moving the target site in a predetermined direction, the magnetic anchor contains a magnetic material and can be ruptured by a needle-like member, and inside the bag body It is characterized by having a filled liquid.
[0013]
In this embodiment, it is practical that the liquid is physiological saline.
[0014]
Also in this aspect, it is preferable that the bag body ruptured by the needle-like member can be sucked and attached to the outlet portion of the suction channel of the endoscope.
[0015]
Further, the bag body that has been ruptured by the needle-like member may be graspable by a grasping forceps that can be inserted into a forceps channel of an endoscope, and may be recoverable via the forceps channel.
[0016]
In any aspect, it is practical that the connecting member connected to the magnetic anchor and the gripping member is a flexible connecting string.
[0017]
Further, in any aspect, the magnetic anchor guiding device generates a magnetic force by a generated magnetic field, and moves the magnetic anchor in a predetermined direction by the magnetic force. A one-plane moving mechanism for moving along a U-shaped frame member arranged in a plane; and a one-way moving mechanism for relatively moving the U-shaped frame member in a direction perpendicular to the one plane. It is practical.
[0029]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, a first embodiment of the present invention will be described with reference to FIGS. The magnetic anchor remote guidance system of this embodiment includes a magnetic anchor device 10 (consisting of a gripping member 11, a magnetic anchor 12, a connecting string 13, a traction separating member 14, and a cylindrical fastening member 15) The operation device 30 performs a separation operation from the endoscope 20 and the magnetic anchor guide device 40 that controls the magnetic anchor device 10 to be attracted outside the body (applies a magnetic force to the magnetic anchor 12).
[0030]
First, the configuration of the magnetic anchor device 10 will be described with reference to FIGS. 1 to 3.
The gripping member 11 having a symmetric shape is an elastic member obtained by bending a metal plate, and in a free state, a C-ring-shaped base portion 11a with which the tip ends of both sides come into contact with each other, and extending while extending forward from the tip end of the base portion 11a. A pair of inclined pieces 11b, 11b to be opened, open / close pieces 11c, 11c extending in parallel to each other from the tips of the two inclined pieces 11b, 11b, and claws extending inwardly from the tips of the open / close pieces 11c, 11c Parts 11d and 11d. Further, an insertion hole 11a1 is formed in the rear end portion of the base portion 11a.
[0031]
The magnetic anchor 12 is obtained by filling a magnetic fluid (not shown) into a bag body 12a made of natural rubber or silicone rubber. Examples of the magnetic fluid include those in which ferromagnetic fine particles such as magnetite (Fe ₃ O ₄ ) are dispersed in a solvent such as water or oil. The mouth portion 12a1 of the bag body 12a is tightly bound by a flexible connecting string 13, so that the magnetic fluid does not leak from the mouth portion 12a1. Further, the intermediate portion of the connecting string 13 is inserted through the hollow portion of the base portion 11 a of the gripping member 11.
[0032]
The pulling / separating member 14 is a rod-shaped member, and at the tip thereof is engaged with a pair of insertion pieces 14a penetrating the insertion hole 11a1 of the gripping member 11 and the inner surface of the base portion 11a provided at the tip of the insertion piece 14a. Thus, a retaining portion 14b that prevents the insertion piece 14a from slipping out of the base portion 11a is provided. Furthermore, a flange portion 14 c is formed at the proximal end portion of the traction separation member 14. The pulling / separating member 14 is formed from a metal material such as plastic or SUS, and has such a strength that it can be cut when receiving a strong force exceeding a predetermined cutting force.
[0033]
The cylindrical fastening member 15 having both ends opened as shown in FIGS. 1 to 3 and the like is made of a flexible material. The cylindrical fastening member 15 is formed with a pair of slits 15 a that face in the same direction as the cylindrical fastening member 15. The front end of the slit 15a is open and the rear end is closed. Further, the inner diameter of the cylindrical fastening member 15 is such that the base 11a of the gripping member 11 and the inclined piece 11b can be fitted.
[0034]
From the state shown in FIG. 1 (the state in which the gripping member 11 is not fitted in the cylindrical fastening member 15), when the traction separation member 14 is pulled backward relative to the cylindrical fastening member 15, As shown in FIG. 2, the base 11a of the gripping member 11 is drawn into the cylindrical fastening member 15 while being elastically deformed inward. Then, the diameter of the base portion 11a is reduced, and the both inclined pieces 11b and the both open / close pieces 11c are in an open state in which they are separated from each other.
As shown in FIG. 3, when the traction separating member 14 is pulled further rearward relative to the cylindrical fastening member 15, the gripping member 11 is elastically deformed inward and enters the inside of the cylindrical fastening member 15. Further, the inclined piece 11b comes into contact with the tip opening of the cylindrical fastening member 15, and the open / close pieces 11c and the claws 11d come close to each other.
[0035]
FIG. 4 shows an endoscope 20 used to perform a resection using an anchor remote guidance system.
As is well known, the endoscope 20 has an insertion portion 21 that is soft and flexible and is inserted into the body, and the distal end surface 22 is supplied with air and water for supplying air and cleaning water. Nozzle (not shown), illumination window (not shown) for illuminating the excision part and the periphery thereof, observation window for observing the excision part and the periphery thereof, in which the objective lens and the image sensor are arranged immediately afterward, FIG. And the outlet 23 (not shown) of the suction channel (not shown) provided in the endoscope 20 to which negative pressure is applied, and the outlet 23 of the forceps channel C shown in FIG.
[0036]
Next, the operation device 30 inserted into the forceps channel C of the endoscope 20 will be described with reference to FIG.
The insertion tube 31 is a flexible cylindrical member that can be inserted into the forceps channel C from the entrance 24 a of the forceps port 24 of the endoscope 20, and the total length thereof is longer than that of the forceps channel C. Further, the inner diameter is such that the gripping member 11 and the cylindrical fastening member 15 in the state of FIG. 1 can be inserted. A cylindrical insertion coil 32 that is movable relative to the insertion tube 31 is inserted into the insertion tube 31. A small-diameter portion 33b of a regulation tube 33 composed of a large-diameter portion 33a and a small-diameter portion 33b is fitted to the distal end portion of the insertion coil 32, and the small-diameter portion 33b is distal to the distal end of the insertion coil 32 by an adhesive, solder, brazing, or the like. It is fixed to the part.
[0037]
The outer diameter of the large diameter portion 33 a is smaller than the inner diameter of the insertion tube 31 and is set to be substantially the same as the outer diameter of the insertion coil 32. Furthermore, the inner diameter of the large-diameter portion 33a is larger than the inner diameter of the small-diameter portion 33b and is set to be substantially the same as the outer shape of the cylindrical fastening member 15, and the inner surface of the large-diameter portion 33a is connected to the inner surface of the small-diameter portion 33b. An annular step 33a1 perpendicular to the axis of the restriction tube 33 is formed (see FIG. 7 and the like).
[0038]
Inside the insertion coil 32 inserted into the forceps channel C, an operation wire 35 provided with a hook portion 34 at the tip is inserted so as to be movable relative to the insertion coil 32 and the regulation tube 33. The hook portion 34 has a proximal end portion fixed to the distal end portion of the operation wire 35 by an adhesive, solder, brazing, or the like.
Furthermore, each base end part of the insertion tube 31, the insertion coil 32, and the operation wire 35 is connected with the operation part (not shown) of the operating device 30, and is mutually movable to an axial direction.
The operation device 30 is configured by the insertion tube 31, the insertion coil 32, the restriction tube 33, the hook portion 34, the operation wire 35, and the operation portion described above.
[0039]
Next, the configuration of the magnetic anchor guidance device 40 that controls the magnetic anchor 12 outside the body of the patient A will be described with reference to FIGS. 5 and 6.
A pair of XY stages (one-way moving mechanisms) 42 and 42 are disposed on both sides of the bed 41 having a floor plate 41a on which the patient A is placed. The pair of XY stages 42 reciprocate linearly along the longitudinal direction of the bed 41 so that the longitudinal positions of the both 42 and 42 are always the same. Further, above the bed 41, a frame / rail (two-plane moving mechanism) composed of two rails 44 and 45 that are substantially U-shaped in front view and are parallel to each other in a plane orthogonal to the longitudinal direction of the bed 41. 43, and both ends of the frame / rail 43 are fixed to the left and right XY stages 42, respectively. The inner rail 44 is slidably mounted with a magnetic induction member 46 that controls the magnetic anchor 12 outside the body (which exerts a magnetic force on the magnetic fluid in the magnetic anchor 12). It can move along the rail 45 between the XY stages 42. The magnetic induction member 46 is obtained by fixing an electromagnet 47 having a structure in which a coil is wound around an iron core on a base 48, and the electromagnet 47 always faces the patient A side (see FIG. 5). The magnetic induction member 46 may be a combination of a permanent magnet and an electromagnet, or a combination of two or more permanent magnets and electromagnets.
[0040]
A counterweight 49 for maintaining the weight balance of the entire frame / rail 43 is slidably mounted on the rail 45 on the rail 45 outside the frame / rail 43. The position of the counterweight 49 changes depending on the position of the magnetic induction member 46. For example, when the magnetic guide member 46 is located on the front side of the patient A, the counterweight 49 is located on the back side of the patient A, and when the magnetic guide member 46 is on the back side of the patient A, the counterweight 49 is Located on the front side of the patient A, the entire frame / rail 43 is balanced in weight.
The magnetic guide member 40, the XY stage 42, and the frame / rail 43 described above constitute the magnetic anchor guide device 40.
[0041]
Next, the excision procedure of the lesion X using the magnetic anchor remote guidance system will be described.
Prior to performing excision using the anchor remote guidance system, first, as shown in FIGS. 5 and 6, the patient A subjected to local anesthesia is laid on the floor plate 41 a of the bed 41. At this time, the XY stage 42 is operated so that the longitudinal direction position of the bed 41 of the frame / rail 43 is substantially the same position as the head A1 of the patient A, and the magnetic induction member 46 and the counterweight 49 are set to a predetermined position. Keep it in the place.
Next, the XY stage 42 is operated to place the frame / rail 43 on the front side of the patient A, and the magnetic guiding device 46 is moved along the frame / rail 43 to start excision of the magnetic guiding member 46. Position at the hour position (see FIG. 6).
[0042]
Next, a flexible overtube (not shown) is inserted from the mouth of patient A into the body. Subsequently, the insertion portion 21 of the endoscope 20 is inserted into the overtube, the distal end portion of the insertion portion 21 is protruded from the distal end of the overtube, and the lesion of the organ (target) B (see FIGS. 8 to 13) is detected. It is made to approach the part (target part) X (not shown). Thus, when the distal end of the insertion portion 21 of the endoscope 20 is inserted into the organ B, the observation image in the organ B obtained from the observation window provided on the distal end surface 22 of the insertion portion 21 of the endoscope 20. Is displayed on a television monitor (not shown).
[0043]
Next, a tube-like treatment tool (not shown) having an injection needle at the tip is inserted into the forceps channel C from the inlet 24 a of the forceps port 24, and the injection needle protrudes from the outlet 23 of the forceps channel C. Then, an injection needle is inserted from the periphery of the lesioned part X into the submucosal layer B1 of the organ wall and physiological saline or the like is injected, and the lesioned part X is lifted from the proper muscle layer B2 (see FIGS. 8 to 13). .
[0044]
Subsequently, the treatment tool is taken out from the forceps channel C. Next, the operation device 30 in which the insertion tube 31, the insertion coil 32, the restriction tube 33, the hook portion 34, the operation wire 35, and the operation portion are integrated is inserted into the forceps channel C from the forceps port 24.
Since the insertion tube 31 is longer than the forceps channel C as described above, the proximal end portion of the insertion tube 31 protrudes behind the forceps port 24 (not shown). Furthermore, since the operation wire 35 is sufficiently longer than the insertion tube 31, the proximal end portion of the operation wire 35 protrudes further rearward of the proximal end portion of the insertion tube 31 protruding from the forceps port 24 (not shown).
Further, since the cylindrical fastening member 15 is formed from a flexible material and the insertion coil 32 is bendable, these members can be retained in the forceps channel C even when the insertion portion 21 is bent. It can move smoothly.
[0045]
When the distal end of the operation device 30 reaches the distal end portion of the forceps channel C, the proximal end portion of the operation wire 35 protruding from the forceps opening 24 is grasped, and the operation wire 35 is operated so that only the hook portion 34 is endoscope 20. The operation wire 35 is pulled toward the operation portion side by engaging the hook portion 34 with the hook portion 14 c of the pulling separation member 14. Then, as shown in FIG. 7, the proximal end portion of the cylindrical fastening member 15 is fitted into the large diameter portion 33a of the restriction tube 33, and the gripping member 11 and the traction connecting member 14 are accommodated in the forceps channel. Further, a part of the magnetic anchor 12 is accommodated in the forceps channel C, and the magnetic anchor device 10 and the operating device 30 are integrated.
[0046]
When the magnetic anchor device 10 and the operating device 30 are set in the endoscope 20 as described above, the proximal end portion of the insertion tube 31 protruding from the forceps port 24 is grasped, and the insertion tube 31 is inserted as shown in FIG. The distal end of the portion 21 is moved to protrude from the distal end surface 22, and the magnetic anchor 12 is pushed out from the forceps channel C.
Next, the insertion coil 32 is moved to the distal end side of the insertion portion 21, the gripping member 11 is protruded from the distal end of the insertion tube 31, and the gripping member 11 is brought close to the lesioned part X. When the operation wire 35 is pulled backward relative to the endoscope 20 in this state, the base 11a of the gripping member 11 is pulled into the cylindrical fastening member 15, and the gripping member 11 is in the open state shown in FIG. It becomes.
[0047]
When the operation wire 35 is further pulled rearward, the base 11 a of the gripping member 11 is further pulled rearward inside the cylindrical fastening member 15, and the inclined piece 11 b comes into contact with the distal end opening of the cylindrical fastening member 15. Therefore, the opening / closing piece 11c of the gripping member 11 is closed, and both the claw portions 11d firmly grip the lesioned part X (see FIG. 9).
[0048]
In this state, when the operation wire 35 is pulled backward with a force greater than the above cutting force, the traction separating member 14 engaged with the hook portion 34 is cut at the intermediate portion, and as a result, the magnetic anchor device 10 Is separated from the operation wire 35 (see FIG. 10).
[0049]
Subsequently, as shown in FIG. 11, when the magnetic field generated by the magnetic induction member 46 arranged outside the body of the patient A is strengthened to exert a magnetic force on the magnetic fluid in the magnetic anchor 12, the magnetic anchor 12 is shown in FIG. The connecting cord 13 moves upward in FIG. 11 while tensioning the slit 15a, and the gripping member 11 moves in the direction of magnetic force (upward in FIG. 11). As a result, the lesion X gripped by the gripping member 11 is also lifted by a sufficient distance in the same direction.
[0050]
Thus, when the lesioned part X is moved by a desired distance in the desired direction, a sufficiently large excision part is formed at the boundary between the lesioned part X and the normal tissue. Then, the operation wire 35 is taken out from the endoscope 20, and as shown in FIG. 11, an incision tool such as a high-frequency knife 50 is inserted into the organ B by using the forceps channel C of the endoscope 20 (not shown in FIG. 11). The lesioned part X is excised together with the mucous membrane from one end side.
Then, when the lesioned part X is excised from one end side to the opposite end side, the entire lesioned part X is eventually completely excised (see FIG. 12).
At the time of excision work with the high-frequency knife 50, the position of the tip 50a of the high-frequency knife 50 becomes easier to confirm as the excision area is expanded.
[0051]
When the excision work is completed as described above, the lesioned part X separated from the normal tissue remains in the state of being gripped by the gripping member 11 (magnetic anchor device 10), and thus the lesioned part X is prevented from being lost.
In order to collect the excised lesion X, the forceps channel C of the endoscope 20 is usually provided with a pair of gripping pieces 61 that can be opened and closed at the distal end thereof, and an operation unit ( Inserting a grasping forceps 60 (not shown in the figure) (see FIG. 13) and operating this operation part, the traction separating member 14 is securely grasped by both the gripping pieces 61 (not shown in the figure) The endoscope 20 is removed from the body, and the lesion X is taken out of the body together with the magnetic anchor device 10.
[0052]
In addition, as shown in FIG. 12, when the connecting string 13 is cut after the excision of the lesion X during the operation and the magnetic anchor 12 and the gripping member 11 are separated, the forceps channel C of the endoscope 20 is removed. Further, the needle-like member 70 having a sharp tip 70a is inserted, and the bag body 12a is ruptured by the tip 70a (see FIG. 13). When the bag body 12a is ruptured in this way, the magnetic fluid flows from the inside of the bag body 12a into the organ B and the bag body 12a is deflated. Therefore, the grasping forceps 60 is inserted into the forceps channel C of the endoscope 20, The bag body 12a is gripped by the gripping pieces 61, and the bag body 12a is taken out of the body together with the endoscope 20.
In this case, the integrated body of the gripping member 11, the pulling separation member 14, and the cylindrical fastening member 15 that grips the lesioned part X can be visualized by gripping the pulling separation member 14 with the gripping forceps 11. Collected outside the body together with the mirror 20.
Furthermore, the magnetic fluid that has flowed into the organ B is sucked into the endoscope 20 from the outlet of the suction channel by applying a negative pressure to the suction channel of the endoscope 20, and then discharged outside the body.
[0053]
When the magnetic anchor device 10 and the lesioned part X are taken out from the body in this way, treatments such as suturing and disinfection of the excised part are performed.
[0054]
Thus, if the anchor remote guidance system of this embodiment is used, even if the connecting string 13 is cut and the magnetic anchor 12 is separated from the gripping member 11 after excision of the lesion X, the bag of the magnetic anchor 12 is removed. By rupturing the body 12a, the deflated bag body 12a can be easily and reliably gripped by the gripping forceps 60, so that the bag body 12a can be easily recovered outside the body.
[0055]
Further, since the lesioned part X can be moved in a desired direction by a sufficient distance, the excised part at the boundary between the lesioned part X and the normal tissue can be easily and reliably secured with a sufficient size. Even if the lesioned part X has a flat shape, a sufficiently large excision part can be created. Even in such a case, the lesioned part X can be easily excised. .
[0056]
In addition, since the lesioned part X is lifted by the gripping member 11, a sufficient excised part can be secured, and the already excised lesioned part X can be prevented from falling on the proper muscle layer B2.
In addition, since the gripping member 11 can be arranged at an arbitrary position, the view of the endoscope 20 is not hindered by the excised lesioned part X.
[0057]
Next, a second embodiment of the present invention will be described with reference to FIG.
The same members as those in the first embodiment are designated by the same reference numerals, and detailed description thereof is omitted.
[0058]
The anchor remote guidance system of this embodiment includes a magnetic anchor device 80 (consisting of a gripping member 11, a magnetic anchor 81, a connecting string 13, a traction separating member 14, and a cylindrical fastening member 15) and an operating device 30. It is.
[0059]
The bag 81a of the magnetic anchor 81 of this embodiment is a mixture of silicone rubber and magnetic fluid, and has the property of being attracted by magnetic force. Further, the inside of the bag body 81a is filled with a non-magnetic liquid such as physiological saline. An example of the magnetic fluid in this case is one in which ferromagnetic fine particles such as iron oxide are dispersed in a solvent such as water or oil.
[0060]
The magnetic anchor device 80 is inserted into the organ B while being attached to the endoscope 20 in the same manner as in the first embodiment, and then the holding member 11 holds the lesion X.
Then, the bag 81a of the magnetic anchor 81 is attracted upward in FIG. 14 by the magnetic field generated from the magnetic induction member 46, and the lesioned part X also moves in the same direction, so that it is formed at the boundary between the lesioned part X and the normal tissue. The excised part is excised with the high-frequency knife 50.
[0061]
After the excision, when the connecting string 13 is cut, the needle-like member 70 (not shown in FIG. 14) is inserted into the organ B using the forceps channel C of the endoscope 20, and the bag body 81a is inserted at the tip 70a. Is ruptured, physiological saline flows out from the inside of the bag body 81a into the organ B, the bag body 81a is gripped by the gripping forceps 60 (not shown in FIG. 14), and taken out of the body.
[0062]
As described above, even in the anchor remote guidance system according to the present embodiment, the magnetic anchor 81 is attached to the needle-like member 70 and the grasping forceps even if the connecting string 13 is cut after the lesion X is excised, as in the first embodiment. 60 can be easily and reliably collected outside the body.
[0063]
Although the present invention has been described with reference to the above embodiment, the present invention is not limited to the above embodiment, and can be improved or changed within the scope of the purpose of the improvement or the idea of the present invention. For example, the ruptured bag bodies 12a and 81a can be sucked by the endoscope 20 in which a negative pressure is applied to the suction channel, and the bag bodies 12a and 81a can be recovered outside the body.
[0064]
【The invention's effect】
As described above, according to the present invention, it is possible to quickly and easily excise a target portion, and to easily and reliably collect a magnetic anchor inserted into the target.
[Brief description of the drawings]
FIG. 1 is an overall view of a magnetic anchor device according to a first embodiment of the present invention.
FIG. 2 is an overall view of the magnetic anchor device with a gripping member open.
FIG. 3 is an overall view of the magnetic anchor device in a state where a gripping member is closed.
FIG. 4 is an overall view of an endoscope.
FIG. 5 is a view of a bed on which a patient whose lesion is to be excised and a magnetic anchor guide device are viewed from the patient's head side.
FIG. 6 is a side view of a bed on which a patient is placed and a magnetic anchor guiding device.
FIG. 7 is an enlarged longitudinal side view of the distal end portion of the endoscope showing a state in which the operating device is inserted into the forceps channel in a state linked to the magnetic anchor device.
FIG. 8 is an enlarged longitudinal sectional side view showing a state immediately before the grasping member protruding from the distal end of the endoscope in the opened state grasps a lesioned portion.
FIG. 9 is an enlarged longitudinal sectional side view showing a state where a gripping member protruding from the distal end of the endoscope is closed and a lesioned part is gripped.
FIG. 10 is an enlarged longitudinal side view showing a state where the magnetic anchor device and the operating device are separated inside the endoscope.
FIG. 11 is an enlarged longitudinal sectional side view showing a state in which a lesioned part is lifted by using a magnetic anchor guiding device after the gripping member grips the lesioned part.
FIG. 12 is a diagram showing a state in which a bag of a magnetic anchor separated from a gripping member is torn with a needle-like member.
FIG. 13 is a view showing a state in which a bag body that has been torn by a needle-like member is collected by gripping forceps.
FIG. 14 is an enlarged vertical side view showing a state where a lesion is being lifted using a magnetic anchor according to a second embodiment of the present invention.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 10 Magnetic anchor apparatus 11 Gripping member 11a Base part 11a1 Insertion hole 11b Inclined piece 11c Opening / closing piece 11d Claw part 12 Magnetic anchor 12a Bag body 12a1 Mouth part 13 Connecting string 14 Pulling separation member 14a Insertion piece 14b Retaining part 14c Ridge part 15 Cylindrical shape Tightening member 20 Endoscope 21 Insertion portion 22 Tip surface 23 Forceps channel outlet 24 Forceps port 24a Inlet 30 Operating device 31 Insertion tube 32 Insertion coil 33 Restriction tube 33a Large diameter portion 33a1 Annular step portion 33b Small diameter portion 34 Hook portion 35 Operation wire 40 Magnetic anchor guide device 41 Bed 41a Floor plate 42 XY stage (unidirectional movement mechanism)
43 Frame / rail (moving mechanism in one plane)
44 45 Rail 46 Magnetic induction member 47 Electromagnet 48 Base 49 Counterweight 50 High-frequency knife 50a Tip portion 60 Grip forceps 61 Grip piece 70 Needle member 70a Tip 80 Magnetic anchor device 81 Magnetic anchor 81a Bag body 81b Mouth portion A Patient (object) )
A1 head B organ B1 submucosa B2 proper muscle layer C forceps channel X lesion (target site)

Claims (11)

A gripping member capable of gripping a target portion inside the target object;
A magnetic anchor containing a magnetic material connected to the gripping member;
A magnetic anchor guiding device that is arranged outside the object and generates a magnetic field,
An endoscopic magnetic anchor remote guidance system that moves the magnetic anchor by a magnetic force generated from the magnetic field generated by the magnetic anchor guiding device and moves a target portion gripped by the gripping member in a predetermined direction,
The magnetic anchor remote guide for an endoscope, wherein the magnetic anchor has a flexible bag body that is not magnetically shieldable and can be ruptured by a needle-like member, and a magnetic fluid filled in the bag body system. The endoscope remote magnetic anchor guidance system according to claim 1, wherein the bag body is made of rubber. The endoscope magnetic anchor remote guidance system according to claim 1 or 2, wherein the bag body ruptured by the needle-like member can be attracted and attached to an outlet portion of an aspiration channel of the endoscope. Anchor remote guidance system. The magnetic anchor remote guidance system for an endoscope according to any one of claims 1 to 3, wherein the magnetic fluid flowing out from the bag body ruptured by the needle-like member is sucked and collected from the suction channel of the endoscope. Endoscopic magnetic anchor remote guidance system is possible. The endoscope magnetic anchor remote guidance system according to claim 3 or 4, wherein the bag body ruptured by the needle-like member can be gripped by gripping forceps that can be inserted into a forceps channel of the endoscope and the forceps. Endoscopic magnetic anchor remote guidance system that can be retrieved through a channel. A gripping member capable of gripping a target portion inside the target object;
A magnetic anchor containing a magnetic material connected to the gripping member;
A magnetic anchor guiding device that is arranged outside the object and generates a magnetic field,
In the endoscope magnetic anchor remote guidance system for moving the magnetic anchor in a predetermined direction by moving the magnetic anchor by the magnetic force generated from the magnetic field generated by the magnetic anchor guiding device,
The magnetic anchor remote guidance system for an endoscope, wherein the magnetic anchor includes a flexible bag body that contains a magnetic material and can be ruptured by a needle-like member, and a liquid filled in the bag body. The magnetic anchor remote guidance system for endoscopes according to claim 6, wherein the liquid is physiological saline. 8. The endoscopic magnetic anchor remote guidance system according to claim 6 or 7, wherein the bag body ruptured by the needle-like member can be attracted and attached to an outlet portion of an aspiration channel of the endoscope. Anchor remote guidance system. In the magnetic anchor remote guidance system for endoscopes according to any one of claims 6 to 8,
The magnetic anchor remote guidance system for an endoscope, wherein the bag body ruptured by the needle-like member can be grasped by a grasping forceps that can be inserted into a forceps channel of an endoscope and can be collected through the forceps channel. 10. The endoscopic magnetic anchor remote guidance system according to claim 1, wherein the connecting member that connects the magnetic anchor and the gripping member is a flexible coupling string. Guidance system. The endoscope magnetic anchor remote guidance system according to any one of claims 1 to 10,
The magnetic anchor guiding device is
A magnetic induction member that generates a magnetic force by a generated magnetic field and moves the magnetic anchor in a predetermined direction by the magnetic force;
An in-plane movement mechanism for moving the magnetic induction member along a U-shaped frame member arranged in a specific plane;
A one-way moving mechanism for relatively moving the U-shaped frame member in a direction orthogonal to the one plane;
An endoscopic magnetic anchor remote guidance system.

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