JP4360838B2 - Endoscope anchor remote guidance system - Google Patents

Description

[0001]
【Technical field】
The present invention relates to an endoscopic anchor remote guidance system used when 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]
In this magnetic anchor remote guidance system, when the magnetic force is strong, the bottom surface of the magnetic anchor may come into contact with the inner wall of the organ. However, since the conventional magnetic anchor has a spherical shape, the contact area between the magnetic anchor and the inner wall of the organ is small, and there is a risk that a strong pressure is locally applied from the magnetic anchor to the inner wall of the organ.
On the other hand, when the size of the magnetic anchor itself is increased in order to increase the contact area of the magnetic anchor with the inner wall of the organ, the cost of the magnetic anchor increases and the work of inserting the magnetic anchor into the body becomes difficult.
[0007]
OBJECT OF THE INVENTION
An object of the present invention is to provide a remote guidance system for an anchor for an endoscope in which the size of the anchor itself is not changed from the conventional one, and when the anchor contacts the object, a strong pressure is not locally applied to the object. Is to provide.
[0008]
Summary of the Invention
An endoscope anchor remote guidance system according to the present invention is disposed outside a target object, a gripping member capable of gripping a target part inside the target object, a magnetic anchor made of a magnetic material connected to the gripping member, A magnetic anchor guide device that generates a magnetic field, and the magnetic anchor is moved by a magnetic force from the magnetic field generated by the magnetic anchor guide device to move a target portion gripped by the gripping member in a predetermined direction. An endoscope remote guidance system for endoscope, wherein the bottom surface of the magnetic anchor located on the side opposite to the end on the connection side with the gripping member has a circular , convex or concave shape that can contact the object. and eggplant contact surface, is characterized in that a larger radius of curvature than the radius of the contact surface.
[0009]
According to another aspect, an endoscope anchor remote guidance system according to the present invention includes a gripping member capable of gripping a target portion inside a target object, a magnetic anchor made of a magnetic material connected to the gripping member, and A magnetic anchor guiding device that is arranged outside the object and generates a magnetic field. The magnetic anchor is moved by the magnetic force generated by the magnetic anchor guiding device and gripped by the gripping member. An endoscope anchor remote guidance system for moving a target part in a predetermined direction, wherein the bottom surface of the magnetic anchor opposite to the end on the connection side with the gripping member has a polygonal shape, The contact surface having a convex shape or a concave shape that can contact the object surrounded by the tangent circle is characterized in that its radius of curvature is larger than its radius.
[0010]
In these embodiments, it is practical to connect the magnetic anchor and the gripping member with a flexible connecting string.
[0011]
The magnetic anchor guide device generates a magnetic force by a generated magnetic field, and moves the magnetic anchor in a predetermined direction by the magnetic force, and a U-shape in which the magnetic guide member is arranged in a specific plane. It is practical to have an in-plane moving mechanism that moves along the frame member and a unidirectional moving mechanism that relatively moves the U-shaped frame member in a direction perpendicular to the one plane.
[0012]
Furthermore, according to another aspect, the remote anchor guidance system for an endoscope of the present invention is a gravitational anchor comprising a gripping member capable of gripping a target portion inside a target object and a non-magnetic material connected to the gripping member. An endoscope anchor remote guidance system that moves the gravity anchor according to gravity and moves the target portion gripped by the gripping member downward in the direction of gravity. The bottom surface located on the side opposite to the connection side end with the gripping member is a circular contact surface that can contact the object, and the radius of curvature is larger than the radius of the contact surface.
[0013]
Furthermore, according to another aspect, the remote anchor guidance system for an endoscope of the present invention is a gravitational anchor comprising a gripping member capable of gripping a target portion inside a target object and a non-magnetic material connected to the gripping member. An endoscopic anchor remote guidance system for moving the target site gripped by the gripping member downward in the direction of gravity by moving the gravity anchor according to gravity, The bottom surface located on the opposite side of the connection side end with the gripping member has a polygonal shape, and the radius of curvature of the contact surface that can be in contact with the object surrounded by the inscribed circle of the bottom surface is larger than the radius. It is characterized by that.
[0014]
In these modes, it is practical to connect the gravity anchor and the gripping member with a flexible connecting string.
[0027]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, a first embodiment of the present invention will be described with reference to FIGS.
The anchor remote guidance system of the present 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) and an internal view of the magnetic anchor device 10. The operation device 30 performs a separation operation from the mirror 20 and the like, 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).
[0028]
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.
[0029]
The magnetic anchor 12 has a substantially conical shape, and the bottom surface thereof is a contact surface 12 a that can contact the inner wall of the organ B. The contact surface 12a is a flat surface having no unevenness. That is, since the curvature radius of the contact surface 12a is infinite, the curvature radius of the contact surface 12a is larger than that radius. Further, the magnetic anchor 12 is entirely formed of a ferromagnetic material. Specific examples of the ferromagnetic material include pure iron, iron alloy, platinum magnet, rare earth magnet, terbium / dysprosium / iron alloy, and the like. There are magnets.
[0030]
Both ends of a flexible connecting cord 13 are fixed to the apex located on the opposite side of the contact surface 12 a of the magnetic anchor 12, and the intermediate portion of the connecting strap 13 is a hollow portion of the base portion 11 a of the gripping member 11. Is inserted, the magnetic anchor 12 and the gripping member 11 are connected.
[0031]
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.
[0032]
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.
[0033]
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.
[0034]
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. A nozzle (not shown), an illumination window (not shown) for illuminating the excision part and its periphery, an observation window for observing the excision part and its periphery, in which an objective lens and an image sensor are arranged immediately after, and a diagram An outlet 23 of the forceps channel C shown in 7 etc. is provided. The forceps channel C is formed in the insertion portion 21, the inlet 24 a is formed on the end surface of the forceps insertion opening projection 24, and the outlet 23 is tapered so that the diameter of the distal end is increased.
[0035]
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.
[0036]
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).
[0037]
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.
[0038]
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 for attracting and controlling the magnetic anchor 12 outside the body (which exerts a magnetic force on the magnetic anchor 12). The magnetic induction member 46 is attached to the left and right XY stages 42. It is possible to move along the rail 45. 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.
[0039]
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.
[0040]
Next, the excision procedure of the lesion X using the 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).
[0041]
Next, a flexible overtube (not shown) is inserted into the body from the mouth of the patient A, and the distal end of the overtube is inserted into the lesion in the organ B (target) (see FIGS. 8 to 12). Close to the part (target part) X. 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 is brought close to the lesioned portion 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).
[0042]
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 12). .
[0043]
Subsequently, the treatment tool is taken out from the forceps channel C, and the insertion tube 31 is inserted into the forceps channel C instead. As described above, since the insertion tube 31 is longer than the forceps channel C, when the insertion tube 31 is inserted into the forceps channel C, the base end portion protrudes from the forceps port 24 (not shown).
Next, outside the endoscope 20, the proximal end portion of the cylindrical fastening member 15 is fitted into the large diameter portion 33 a of the restriction tube 33 fixed to the distal end of the insertion coil 32, and the rear end surface thereof is an annular stepped portion. 33a1 is contacted. Subsequently, the insertion coil 32 is inserted into the insertion tube 31 from the proximal end side, and the operation wire 35 is further inserted into the insertion coil 32, and the insertion tube 31, the insertion coil 32, and the operation wire 35 are inserted. The base end portion is connected to the operation portion. Then, the hook portion 34 fixed to the distal end portion of the operation wire 35 is projected from the distal end surface 22 of the endoscope 20, and the collar portion 14 c of the traction separation member 14 of the magnetic anchor device 10 is engaged with the hook portion 34. Thus, the magnetic anchor device 10 and the operating device 30 are integrated.
At this time, 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.
[0044]
When the operation wire 35 is pulled toward the base end side in the state where the magnetic anchor device 10 and the operation device 30 are integrated in this way, as shown in FIG. 7, the gripping member 11, the connection string 13, and the pulling connection member 14 are The magnetic anchor 12 is fitted into the outlet 23 of the forceps channel C, and most of the magnetic anchor 12 is accommodated in the forceps channel C.
[0045]
When the magnetic anchor device 10 and the operation device 30 are set in the endoscope 20 as described above, the insertion tube 31 is moved to the distal end side of the insertion portion 21 as shown in FIG. 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.
[0046]
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).
[0047]
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).
[0048]
Subsequently, as shown in FIG. 11, when the magnetic anchor 12 is attracted to the upper side of FIG. 11 by strengthening the magnetic field generated by the magnetic guiding member 46 arranged outside the body of the patient A, the connecting string 13 is moved into the slit 15a. 11, the entire contact surface 12a contacts the inner wall of the organ B, and the grasping 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.
[0049]
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.
[0050]
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, as shown in FIG. 12, the forceps channel C of the endoscope 20 has a pair of gripping pieces 61 that can be opened and closed at its distal end, and its proximal end. A grasping forceps 60 having an operation unit (not shown) is inserted into the. Then, by operating this operation section, the gripping piece 61 is brought into the open state to be brought close to the traction separating member 14, and thereafter, the both gripping pieces 61 are closed so that the traction separating member 14 is reliably secured by the both gripping pieces 61. Grasp (see FIG. 12). Then, the endoscope 20 is removed from the body as it is, the lesioned part X is taken out of the body together with the magnetic anchor device 10, and then the excised part is sutured and disinfected.
[0051]
As described above, when the anchor remote guidance system of this embodiment is used, the magnetic anchor 12 is attracted by the magnetic field generated from the magnetic guidance member 46, and the contact surface 12a contacts the inner wall of the organ B with a strong force. However, since the radius of curvature of the contact surface 12a is larger than that radius, the contact area between the two is larger than when a conventional spherical magnetic anchor whose radius is the same as the radius of the contact surface 12a contacts the inner wall of the organ B. Becomes larger. As a result, the contact force per unit contact area is smaller than before, and the organ B is not subjected to a large load locally.
[0052]
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. .
[0053]
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.
[0054]
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.
[0055]
The anchor remote guidance system of this embodiment includes a gravity anchor device 70 (consisting of a gripping member 11, a gravity anchor 71, a connecting string 13, a traction separating member 14, and a cylindrical fastening member 15) and an operation device 30. It is.
[0056]
The outer shape of the gravity anchor 71 is the same as that of the magnetic anchor 12, and the bottom surface thereof is a contact surface 71a, and the whole is formed of a nonmagnetic material. Specific examples of the nonmagnetic material include gold, copper, aluminum, stainless steel (austenite), brass, ceramic, glass, and the like.
[0057]
The gravitational anchor device 70 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 grasping member 11 grasps the lesioned part X.
Since the gravity anchor 71 moves according to the gravity P, when the posture of the patient A is changed and the gravity anchor 71 is moved downward in the gravity direction, the contact surface 71a of the gravity anchor 71 contacts the inner wall of the organ B, and the string As the portion 13 is tensioned, the lesioned portion Y gripped by the gripping member 11 moves downward in the gravity direction. As a result, a sufficiently large excision portion is formed at the boundary between the lesion X and normal tissue, and the lesion X is excised with the high-frequency knife 50.
[0058]
As described above, even with the anchor remote guidance system of this embodiment, even if the contact surface 71a of the gravity anchor 71 contacts the inner wall of the organ B with a strong force, as in the first embodiment, Since the radius of curvature of the contact surface 71a is larger than the radius, the contact area between the two becomes larger than when a conventional spherical anchor whose radius is the same as the radius of the contact surface 71a contacts the inner wall of the organ B, The contact force per unit contact area is smaller than before. As a result, it is possible to prevent a large load from being applied locally to the organ B.
Furthermore, in this embodiment, the magnetic anchor guiding device 40, which is an expensive device necessary in the first embodiment, is not necessary, which is advantageous in terms of cost compared to the first embodiment.
[0059]
In the first embodiment, the same effect as that of the first embodiment can be obtained even if the magnetic anchor has a shape described below.
A convex contact surface 80a is formed at the bottom of the magnetic anchor 80 shown in FIGS. The curvature radius r of the contact surface 80a is set larger than the radius R. Even if the bottom of the magnetic anchor 80 has such a shape, the contact area between the contact surface 80a and the inner wall of the organ B is larger than that of a conventional spherical magnetic anchor whose radius is the same as the radius of the contact surface 80a. Become.
[0060]
Furthermore, a concave contact surface 90a is formed at the bottom of the magnetic anchor 90 shown in FIGS. The curvature radius r1 of the contact surface 90a is set larger than the radius R1. Even if the bottom of the magnetic anchor 90 is formed in such a shape, the contact area between the contact surface 90a and the inner wall of the organ B is larger than that of a conventional spherical magnetic anchor whose radius is the same as the radius of the contact surface 90a. Become.
[0061]
Further, the magnetic anchor 100 shown in FIGS. 18 and 19 has a substantially rectangular parallelepiped shape, and a portion surrounded by the inscribed circle C1 of the substantially square bottom surface 100a is a convex contact surface 100b. . The curvature radius r2 of the contact surface 100b is set larger than the radius R2. Even if the bottom of the magnetic anchor 100 is shaped like this, the contact area between the contact surface 100b and the inner wall of the organ B is larger than that of a conventional spherical magnetic anchor whose radius is the same as the radius of the contact surface 100b. Become.
[0062]
Further, the magnetic anchor 110 shown in FIGS. 20 and 21 has a substantially triangular pyramid shape, and the portion surrounded by the inscribed circle C2 of the substantially triangular bottom surface 110a is a convex contact surface 110b. Yes. The curvature radius r3 of the contact surface 110b is set larger than the radius R3. Even if the bottom of the magnetic anchor 110 is shaped like this, the contact area between the contact surface 110b and the inner wall of the organ B is larger than that of a conventional spherical magnetic anchor whose radius is the same as the radius of the contact surface 110b. Become.
[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 shape of the gravity anchor 71 of the second embodiment can of course be the shape shown in FIGS.
[0064]
【The invention's effect】
As described above, according to the present invention, the size of the anchor itself is not changed, and when the anchor comes into contact with the object, a strong pressure is not locally applied to the object.
[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 magnetic anchor that has gripped a lesioned part is gripped by gripping forceps.
FIG. 13 is an enlarged longitudinal sectional side view showing a state in which a lesion is moved downward in the direction of gravity using the gravity anchor according to the second embodiment of the present invention.
FIG. 14 is a side view of a modified example of the magnetic anchor.
FIG. 15 is a bottom view of a modified example of the magnetic anchor.
FIG. 16 is a side view of another modified example of the magnetic anchor.
FIG. 17 is a bottom view of another modified example of the magnetic anchor.
FIG. 18 is a side view of still another modified example of the magnetic anchor.
FIG. 19 is a bottom view of still another modified example of the magnetic anchor.
FIG. 20 is a side view of still another modified example of the magnetic anchor.
FIG. 21 is a bottom view of still another modified example of the magnetic anchor.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 10 Magnetic anchor apparatus 11 Grasp member 11a Base part 11a1 Insertion hole 11b Inclination piece 11c Opening / closing piece 11d Claw part 12 Magnetic anchor 12a Contact surface 13 Connecting string 14 Pulling separation member 14a Insertion piece 14b Retaining part 14c Ridge part 15 Cylindrical fastening member 20 Endoscope 21 Insertion portion 22 End surface 23 Forceps channel outlet 24 Forceps port 24a Inlet 30 Operation 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 60 Holding forceps 61 Holding member 70 Gravity anchor device 71 Gravity anchor 71a Bottom surface 71b Contact surface 80 Magnetic anchor 80a Contact surface 90 Magnetic anchor 90a Contact surface DESCRIPTION OF SYMBOLS 100 Magnetic anchor 100a Bottom surface 100b Contact surface 110 Magnetic anchor 110a Bottom surface 110b Contact surface A Patient (object)
A1 head B organ B1 submucosa B2 proper muscle layer C forceps channel P gravity r r1 r2 r3 radius of curvature R R1 R2 R3 radius X lesion (target site)

Claims (7)

A gripping member capable of gripping a target portion inside the target object;
A magnetic anchor made of a magnetic material connected to the gripping member;
A magnetic anchor guiding device arranged outside the object and generating a magnetic field;
Comprising
An endoscopic anchor remote guidance system for moving an object site gripped by the gripping member in a predetermined direction by moving the magnetic anchor by a magnetic force from a magnetic field generated by the magnetic anchor guide device,
The bottom surface of the magnetic anchor located on the side opposite to the end on the connection side with the gripping member is a circular , convex or concave contact surface that can contact the object, and its curvature is determined by the radius of the contact surface. Endoscope remote guidance system for endoscopes characterized by a larger radius. A gripping member capable of gripping a target portion inside the target object;
A magnetic anchor made of a magnetic material connected to the gripping member;
A magnetic anchor guiding device arranged outside the object and generating a magnetic field;
Comprising
An endoscopic anchor remote guidance system for moving an object site gripped by the gripping member in a predetermined direction by moving the magnetic anchor by a magnetic force from a magnetic field generated by the magnetic anchor guide device,
The bottom surface of the magnetic anchor located on the opposite side to the end on the connection side with the gripping member has a polygonal shape, and has a convex or concave contact that can contact the object surrounded by an inscribed circle on the bottom surface. An anchor remote guidance system for an endoscope, characterized in that the curvature radius of the surface is larger than the radius. The endoscope anchor remote guidance system according to claim 1 or 2, wherein the magnetic anchor and the gripping member are connected by a flexible connecting string. The endoscope anchor remote guidance system according to any one of claims 1 to 3,
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 endoscope remote guidance system for endoscope. A gripping member capable of gripping a target portion inside the target object;
A gravity anchor made of a non-magnetic material connected to the gripping member,
An endoscope anchor remote guidance system for moving the gravity anchor according to gravity and moving the target portion gripped by the gripping member downward in the direction of gravity,
The bottom surface of the gravity anchor located on the side opposite to the end on the connection side with the gripping member is a circular contact surface that can contact the object, and the radius of curvature is larger than the radius of the contact surface. Endoscope remote guidance system for endoscope. A gripping member capable of gripping a target portion inside the target object;
A gravity anchor made of a non-magnetic material connected to the gripping member,
An endoscope anchor remote guidance system that moves the gravity anchor according to gravity and moves the target part gripped by the gripping member downward in the direction of gravity,
The bottom surface of the gravity anchor located on the opposite side to the end on the connection side with the gripping member has a polygonal shape, and the contact surface that can be in contact with the object surrounded by the inscribed circle of the bottom surface is determined from its radius. An endoscope remote guidance system for an endoscope characterized in that the curvature radius is increased. The endoscope anchor remote guidance system according to claim 5 or 6, wherein the gravity anchor and the gripping member are connected by a flexible connecting string.

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