JP4530715B2 - Insertion aid - Google Patents

Description

The present invention, an insertion assisting again and again relates to impart propulsion force to the insertion portion of the endoscope.

  Conventionally, by inserting an elongated insertion portion into a body cavity, various organs can be observed by observing an organ in the body cavity or by inserting a treatment tool into a treatment tool insertion channel provided in the insertion portion as necessary. Endoscopes that can be used for treatment and treatment are widely used.

  Generally, in an endoscope having an elongated insertion portion, a bending portion is provided on the distal end side of the insertion portion. The bending portion is configured to bend in the up / down direction / left / right direction, for example, by advancing and retracting the operation wire connected to the bending piece constituting the bending portion. The advancement / retraction of the operation wire is performed by the operator turning, for example, a bending knob provided in the operation unit.

  When inserting the endoscope insertion part into a complicated cavity such as the large intestine, such as the large intestine, the operator turns the bending knob to bend the bending part. At the same time, the insertion portion is twisted to introduce the distal end portion of the insertion portion toward the observation target site.

  However, considerable skill is required before the deep part of the large intestine where the insertion part is complicated can be introduced smoothly to the target site in a short time without causing pain to the patient. For this reason, various proposals for improving the introduction of the insertion portion have been made.

  For example, Japanese Patent Application Laid-Open No. 10-113396 discloses a medical device propulsion device that can guide a medical device to a deep portion of a living body tube easily and with minimal invasiveness. In this propulsion device, the rotating member is provided with an inclined rib with respect to the axial direction of the rotating member. Therefore, by rotating the rotating member, the rotational force of the rotating member is converted into propulsive force by the rib. Then, the medical device connected to the propulsion device is moved toward the deep portion by the propulsive force.

  Japanese Patent Laid-Open No. 2001-179700 discloses a movable micromachine and a movement control system thereof. This micromachine is a magnetic micromachine using a magnetic force as a drive source, which uses magnetic torque acting on a micromagnet from an external rotating magnetic field. In this magnetic micromachine, a cable for supplying energy is not required, and it is possible to realize a desired movement with a simple structure, away from restrictions on cables and power supplies. And since it shows a favorable movement characteristic in still water or running water, it has been proved extremely promising in application to medical microrobots.

  Japanese Patent Laid-Open No. 2003-260026 discloses a medical magnetic guidance device that is small and easy to handle without giving a patient a sense of resistance. In this medical magnetic guidance device, an insertion portion such as an endoscope, a catheter, or a guide wire, which is a capsule medical device provided with a magnet, is magnetically guided by a rotating magnetic field formed by a magnetic field generation unit. ing.

  And the endoscope apparatus of the structure shown to FIG.14 and FIG.15 can be easily considered from description of the said Unexamined-Japanese-Patent No. 2003-260026, Unexamined-Japanese-Patent No. 2001-179700, and Unexamined-Japanese-Patent No. 10-113396. it can.

  The endoscope apparatus shown in the figure includes an endoscope 100, a rotation adapter 103 attached to a distal end portion 102 of an insertion portion 101 of the endoscope 100, and a medical magnetic guidance device (not shown) that rotates the rotation adapter 103. And is configured. The rotation adapter 103 is provided with a magnet (not shown) inside, and a helically shaped portion 104 is formed on the outer peripheral surface.

For this reason, by arranging the rotation adapter 103 in the rotating magnetic field indicated by the arrow 105, for example, the rotation adapter 103 is rotated in the direction indicated by the arrow 106 with respect to the insertion portion 101. Therefore, in a state where the insertion unit 101 is inserted through a hollow organ such as the large intestine, the rotating adapter 103 is rotated by applying a rotating magnetic field to the rotating adapter 103. Then, a frictional force is generated by the spiral shaped portion 104 formed on the outer peripheral surface of the rotation adapter 103 coming into contact with the colon wall (not shown), and this frictional force introduces the insertion portion 101 toward a deep portion in the body cavity. You can get the driving force.
JP-A-10-113396 JP 2001-179700 A JP 2003-260026 A

  However, in the endoscope apparatus having the configuration shown in FIGS. 14 and 15, it is more than necessary for the large intestine wall or the like to prevent the large intestine wall or the like from being damaged by the rotation adapter attached to the distal end of the insertion portion. Must be prevented from being overloaded.

  In addition, when the rotary adapter is positioned in the rotating magnetic field, there is a demand for switching between a state in which a propulsive force can be obtained from the rotary adapter and a state in which no propulsive force is required according to the operator's hand operation. there were. In addition, when the rotation adapter attached to the distal end of the insertion portion is not rotated, in other words, when the rotation magnetic field is not applied to the rotation adapter, when the insertion portion is introduced by hand operation, the rotation adapter is By contacting the wall, there is a possibility that the rotating member is idled to cause a problem in introducing the insertion portion.

The present invention has been made in view of the above circumstances, and prevents the unnecessary load from being applied to the large intestine wall from the rotating member provided in the insertion assisting tool, or controls the rotating member by the operator's hand operation. It has the purpose of providing an insertion aid with excellent usability which allows.

  An insertion assisting tool according to the present invention includes a main body disposed in an insertion portion of an endoscope, a rotation holding member fixed to the main body, and a rotation holding member rotatably held by the rotation holding member. A first rotating member that is rotated by a rotating magnetic field from the outside, provided integrally with the means, and disposed on the outer peripheral surface side of the first rotating member, and has a driving force against the insertion portion of the endoscope A second rotating member having an outer peripheral surface provided with a spiral-shaped portion for imparting a rotational force to the second rotating member and transmitting the rotational force of the first rotating member to the second rotating member. And a rotational force transmitting means for making a non-transmitting state when a predetermined external force is applied.

On the other hand, the insertion assisting tool includes a main body disposed in the insertion portion of the endoscope, a rotation holding member fixed to the main body, and a rotation holding member rotatably held by the rotation holding member. And a first rotating member that is rotated by a rotating magnetic field from the outside, and is disposed on the outer peripheral surface side of the first rotating member, and provides a propulsive force to the insertion portion of the endoscope. In the insertion assisting tool comprising the second rotating member provided on the outer peripheral surface with the helical shape portion to be provided,
The rotational force of the first rotating member is transmitted to the second rotating member on the contact surface between the first rotating member and the second rotating member, and a predetermined value is applied to the second rotating member. When the external force is applied, a rotational force transmission surface is provided to make it non-transmission state.

  Therefore, when the rotational force of the first rotating member is transmitted to the second rotating member via the rotational force transmitting means or the rotational force transmitting surface, the second rotating member provided with the spiral-shaped portion is provided. Rotating state.

According to the present invention, an unnecessary load is applied to the body cavity wall by the rotating adapter that generates the propulsive force, and the propulsive force generated from the rotating adapter is used by the operator when desired by the operator. It is possible to provide an insertion aid that is easy to use, such as being able to be introduced.

Embodiments of the present invention will be described below with reference to the drawings.
1 to 8 relate to a first embodiment of the present invention, FIG. 1 is a diagram for explaining the configuration of an endoscope apparatus, FIG. 2 is a longitudinal sectional view for explaining the configuration of a rotary adapter, and FIG. FIG. 4 is a diagram for explaining the relationship between an external magnetic field generated by the medical magnetic guidance device and the spiral provided on the rotary adapter, and FIG. 5 is a bed portion of the medical magnetic guidance device. The figure which shows the state which has inserted the insertion part of the endoscope into the patient who lies in FIG. 6, FIG. 6 introduces the insertion part by the propulsive force generated from the rotation adapter provided in the insertion part of the endoscope FIG. 7 is a longitudinal sectional view for explaining another configuration of the rotary adapter, and FIG. 8 is a sectional view taken along the line BB of FIG.

  As shown in FIG. 1, an endoscope apparatus 1 according to the present embodiment has an endoscope 2 having an insertion portion 21 to be inserted into a body cavity, and when the insertion portion 21 of the endoscope 2 is introduced into the body cavity. And an endoscope insertion assisting device 3 for obtaining a propulsive force of

  The endoscope 2 includes a light source device 4, a camera control unit (hereinafter abbreviated as CCU) 5, and a monitor 6 as external devices. The light source device 4 supplies illumination light to the endoscope 2. The CCU 5 performs signal processing for the solid-state imaging device provided in the endoscope 2. The video signal generated by the CCU 5 is input to the monitor 6. As a result, an endoscopic image is displayed on the display screen 6 a of the monitor 6.

  On the other hand, the endoscope insertion assisting device 3 is mainly composed of a rotation adapter 7 as an insertion assisting tool and a medical magnetic guidance device (hereinafter abbreviated as a magnetic guidance device) 8 that generates a desired external magnetic field. ing. The magnetic induction device 8 includes a control device 9 and a power supply device 10 as external devices.

  The endoscope 2 includes an insertion part 21, an operation part 22 and a universal cord 23. The insertion portion 21 is elongated and flexible. The operation part 22 is connected to the proximal end side of the insertion part 21 and also serves as a grip part. The universal cord 23 extends from, for example, a side portion of the operation unit 22.

The insertion portion 21 is configured by connecting a hard distal end portion 24, a bendable bending portion 25, and a long and flexible flexible tube portion 26 in order from the distal end side.
The operation section 22 is provided with a bending operation knob 27 which is a bending operation means for bending the bending section 25. The operation unit 22 is provided with an air / water supply button 28a for instructing air / water supply and a suction button 28b for instructing suction. Further, the operation unit 22 is provided with a video switch 29a for remotely operating the CCU 5, remote switches 29b and 29c for controlling various peripheral devices, and the like. The operation unit 22 is provided with a forceps port 30 into which a treatment tool such as a biopsy forceps is inserted. The forceps port 30 communicates with a treatment instrument insertion channel (not shown) that passes through the insertion portion 21.

  Therefore, by inserting, for example, biopsy forceps from the forceps opening 30, the biopsy forceps pass through the treatment instrument insertion channel and protrude from the channel opening 24 a formed in the distal end portion 24.

  A forceps plug 30a is attached to the forceps opening 30 to prevent bodily fluids or the like that flow backward in the treatment instrument insertion channel from splashing outside the endoscope 2. Reference numeral 24b denotes an observation window constituting the observation optical system, and reference numeral 24c denotes an illumination window from which illumination light constituting the illumination optical system is emitted.

  In the universal cord 23, a light guide fiber bundle (not shown) whose one end surface faces the illumination window 24c, a signal line extending from the solid-state imaging device, a tube constituting a suction channel, an air / water supply channel, and the like are inserted. An end of the universal cord 23 is provided with an endoscope connector 23 a that is detachably connected to the light source device 4. An electrical connector portion (not shown) is provided on the side portion of the endoscope connector 23a. A connector 11a of an electric cable 11 connected to the CCU 5 is connected to the electric connector portion.

  The rotation adapter 7 constituting the endoscope insertion assisting device 3 is for obtaining a propulsive force when the insertion portion 21 of the endoscope 2 is inserted into a luminal organ such as the large intestine. The rotation adapter 7 is disposed at a predetermined position of the distal end portion 24 constituting the insertion portion 21 of the endoscope 2.

  On the other hand, as shown in FIG. 1, the magnetic guidance device 8 includes a bed 31 on which a patient can lie, for example, and a magnetic field generator 32 configured to cover a desired portion of the patient lying on the bed 31. It is mainly composed of.

The magnetic field generation unit 32 includes a frame body portion 33 and a window portion 34, and the frame body portion 33 is provided with an electromagnetic coil (not shown). Specifically, a pair of electromagnetic coils is provided on each of the three sets of plane portions 33a, 33b, 33c facing each other constituting the frame portion 33 so as to form a Helmholtz coil (not shown). That is, the three sets of Helmholtz coils provided in the magnetic field generator 32 are configured in a substantially cubic shape on the bed 31.
The window 34 is provided so that the patient's neck, legs, arms, and torso can be freely inserted and removed.

  A connection cable 35 extends from the magnetic induction device 8. A connector 35 a is provided at the end of the connection cable 35. The connector 35a is detachably connected to the power supply device 10. The control device 9 is electrically connected to the power supply device 10 through a signal cable 36.

  The control device 9 controls the strength, direction, and the like of the current supplied to the three sets of Helmholtz coils provided in the magnetic field generation unit 32, thereby controlling the X direction, Y in the figure from the magnetic field generation unit 32. It is possible to generate a magnetic field corresponding to each of the direction and the Z direction. That is, the three sets of Helmholtz coils are appropriately controlled to form a desired three-dimensional rotating magnetic field.

  In the present embodiment, the CCU 5 and the control device 9 are electrically connected by the signal cable 37, and the remote switch 29b provided in the operation unit 22 is controlled by, for example, the rotating magnetic field formed by the magnetic induction device 8. It is used as a switch for a guidance device. Therefore, when the surgeon operates the guidance device switch 29b at hand, the magnetic guidance device 8 can be driven to form a desired rotating magnetic field. That is, the instruction signal output by operating the guidance device switch 29 b is transmitted to the magnetic guidance device 8 via the CCU 5 and the control device 9.

  Instead of setting the remote switch 29b as a guidance device switch, a guidance device switch may be provided separately and detachably attached to the operation unit 22, or may be operated by another operator. In this configuration, for example, the guidance switch and the control device 9 are electrically connected.

The configuration and operation of the rotation adapter 7 will be described with reference to FIGS.
As shown in FIGS. 2 and 3, the rotation adapter 7 disposed at the distal end portion 24 of the endoscope 2 indicated by the alternate long and short dash line includes a main body portion 41, a pair of bearing portions 42 that are rotation holding members, A rotating member 43 that is a rotating member, a permanent magnet 44 that is a magnetic field generating means, a helical body 45 that is a second rotating member, a spring member 46 that is a rotating force transmitting means, an adapter component member 47, and the like. It consists of

  The main body 41 has a pipe shape, and a flange 41a is provided at one end. A through-hole 41b into which, for example, the distal end portion 24 is inserted is formed in the central portion of the main body portion 41 in the longitudinal axis direction. The flange 41a is formed with a screw hole (not shown) in which a female screw into which a rotation stop screw (not shown) is screwed is formed so as to communicate with the through hole 41b.

  The rotating body 43 and the permanent magnet 44 are pipe-shaped. The permanent magnet 44 is integrally fixed to the inner peripheral surface of the rotating body 43. The rotating body 43 is disposed on the outer peripheral surface side of the bearing portion 42. Therefore, the permanent magnet 44 is disposed between the pair of bearing portions 42.

  The rotating body 43 is made of, for example, a hard resin. Examples of the permanent magnet 44 include a neodymium magnet, a samarium cobalt magnet, a ferrite magnet, an iron / chromium / cobalt magnet, a platinum magnet, and an Alnico magnet. Ferrite magnets have the advantage of being inexpensive, and platinum magnets have excellent corrosion resistance and are suitable for medical use.

  The spiral body 45 is formed of an elastic body having elasticity such as a rubber member, a soft resin member, or a hard resin. On the outer surface of the spiral body 45, there is provided a spiral projection 45a that is a spiral-shaped portion that generates propulsive force by rotating and contacting the body wall.

  The number, pitch, height dimension, width dimension, and the like of the spiral protrusions 45a provided on the spiral body 45 are appropriately set so as to obtain a desired driving force. Further, the formation range of the spiral protrusion 45a provided on the spiral body 45 is not limited from the vicinity of one end (edge) of the spiral body 45 to the vicinity of the other end as shown in the figure, and a desired propulsive force. Can be provided only in the middle part of the spiral body 45.

  The spring member 46 is formed in a tubular shape from phosphor bronze, for example. For example, three springs 46a are provided at regular intervals in the longitudinal direction and four springs 46a are provided at regular intervals in the circumferential direction to serve as a biasing part that biases the inner peripheral surface of the spiral body 45. is doing. The spring member 46 is integrally fixed to the outer peripheral surface of the rotating body 43.

The biasing force of the spring part 46a is set as follows.
First, in a state where an external force is not applied to the spiral body 45 or a force having a value smaller than an external force of a predetermined magnitude is applied, if the rotary body 43 is rotated, the rotary body 43 is rotated. Is transmitted to the spiral body 45. As a result, the spiral body 45 is rotated. On the other hand, when an external force of a predetermined magnitude or larger is applied to the spiral body 45 from the outside, when the rotating body 43 is rotated, the rotating body 43 idles with respect to the spiral body 45. In this state, the rotational force of the rotating body 43 is not transmitted to the spiral body 45. As a result, the spiral body 45 is in a rotation stopped state even though the rotating body 43 is rotated.

  Therefore, in the present embodiment, the outer diameter of the rotating body 43 and the inner diameter of the spiral body 45 are formed such that a gap that is a predetermined space is formed between the outer peripheral surface of the rotating body 43 and the inner peripheral surface of the spiral body 45. The dimension is set to a predetermined dimension, and the shape and number of the spring portions 46a of the spring member 46 are optimally set.

  The “external force not less than a predetermined magnitude” is a force with a magnitude that may cause damage to the colon wall by the rotating spiral body 45 when the spiral body 45 is rotated in contact with the colon wall. It is. The external force having a predetermined magnitude is a force having a magnitude set in consideration of safety with respect to the “external force having a predetermined magnitude or more” in order to prevent the colon wall from being damaged. Further, the shape of the spring member 46 is not limited to this, and any configuration that can obtain a predetermined biasing force may be used.

  The adapter component member 47 has an annular shape and is fixed to the other end side of the main body 41.

  As shown in FIG. 4, the rotating adapter 7 provided at the distal end portion 24 of the insertion portion 21 of the endoscope 2 is replaced with a rotating magnetic field as indicated by an arrow A formed by the magnetic field generating portion 32 of the magnetic guidance device 8. Place inside. Then, the permanent magnet 44 disposed on the rotating body 43 is rotated under the influence of the rotating magnetic field. Thereafter, the rotational force of the rotating body 43 is transmitted to the spiral body 45 via the spring member 46, so that the spiral body 45 is rotated with respect to the main body 41 as indicated by an arrow B.

The operation of the endoscope apparatus 1 configured as described above will be described.
In inserting the insertion portion 21 of the endoscope 2 into the large intestine, first, a medical person (abbreviated as “staff”) prepares the rotation adapter 7 corresponding to the endoscope 2. Next, the rotation adapter 7 is arranged on the distal end portion 24 constituting the insertion portion 21 by the staff, and then the rotation adapter 7 is fixed to the distal end portion 24 with a rotation stop screw (not shown).

  In addition to the fixed rotation adapter 7, the power source of the light source device 4, the CCU 5, and the monitor 6 that are external devices of the endoscope 2 and the control device 9 and the power supply device 10 that are external devices of the magnetic guidance device 8 are turned on Put it in a state. This completes the preparation for inserting the insertion portion 21 of the endoscope 2 into the large intestine.

  Next, the surgeon places the endoscope 2 in an observation state and supplies a current to each of the three sets of Helmholtz coils provided in the magnetic field generator 32 of the magnetic guidance device 8 to form a predetermined rotating magnetic field. To a state to do. Then, as shown in FIG. 5, the distal end portion where the rotation adapter 7 is provided from the anus of the patient 13 lying on the bed portion 31 of the magnetic guidance device 8 so that the site to be examined is located in the magnetic field generating portion 32. 24 is inserted into the large intestine.

  As shown in FIG. 6, when the rotating adapter 7 disposed at the distal end portion 24 inserted from the anus 71 is disposed in the rotating magnetic field of the magnetic field generating unit 32 indicated by a two-dot chain line, the rotation constituting the rotating adapter 7 is performed. The body 43 rotates, and the rotational force is transmitted to the spiral body 45 via the spring member 46, whereby the spiral body 45 enters a predetermined rotational state as indicated by an arrow.

  Here, a frictional force is generated when the spiral projection 45a provided on the outer peripheral surface of the spiral body 45 is in rotational contact with the colon wall, and the frictional force generated at this time passes through the insertion portion 21 of the endoscope 2 to the tube. This is the driving force for introduction toward the deep part of the cavity. Therefore, the surgeon introduces the insertion portion 21 toward the deep portion as shown by the broken line in FIG. 6 while performing the pushing operation with a small amount of force using the propulsive force obtained by the rotation adapter 7.

  In the rotation adapter 7 of the present embodiment, an external force greater than a predetermined value acts on the spiral body 45 constituting the rotation adapter 7 in the process of obtaining the propulsion force and introducing the insertion portion 21 toward the deep portion. In such a case, the urging force of the spring member 46 is set to a predetermined value in advance, and the rotating body 43 is configured to rotate freely. It becomes idle state. Then, the rotational force from the rotating body 43 is not transmitted to the spiral body 45, so that the rotation of the spiral body 45 is stopped.

  At this time, the surgeon observes the endoscopic image displayed on the display screen 6a of the monitor 6 and controls the rotating magnetic field while confirming the progress and insertion position. In other words, if it is determined that the introduction by the propulsive force is not made, a hand operation such as bending the bending portion 25 or appropriately operating the remote switch 29b as a guidance device switch to change the rotating magnetic field is performed. Do. Then, when the positional relationship between the rotation adapter 7 and the large intestine wall is changed and the external force of a predetermined value or more is released from acting on the spiral body 45, the spiral body 45 starts to rotate again, and the tip The part 24 advances toward the sigmoid colon part 72 by the driving force and the hand operation.

  Thereafter, the surgeon performs a hand operation and a twisting operation for bending the bending portion 25 in a state where the propulsive force by the spiral body 45 is obtained. As a result, the distal end portion 24 of the insertion portion 21 passes through the sigmoid colon portion 72, and further, the bent portion and the descending colon portion which are the boundary between the sigmoid colon portion 72 and the descending colon portion 73 having poor mobility. 73, passing through a splenic curve 75, which is a boundary between the descending colon portion 73 and the movable transverse colon portion 74, and a liver curve 77, which is a boundary between the transverse colon portion 74 and the ascending colon portion 76. It is introduced in the vicinity of a certain cecum 78.

  As described above, the rotating adapter is provided with a rotating body integrally provided with a permanent magnet and a spiral body provided with a spiral protrusion, and the rotational force of the rotating body is transmitted to the spiral body between the spiral body and the rotating body. By arranging a spring member having a spring portion set to a predetermined biasing force, it is ensured that the spiral rotates in a state where the resistance applied to the spiral from the body cavity wall or the like acts as an external force exceeding a predetermined value. Can be prevented.

  This reliably prevents an unnecessarily large load from being applied to the body cavity wall from the rotating spiral body of the rotation adapter.

  Instead of the configuration in which the spring member 46 is disposed in the gap between the spiral body 45 and the rotor 43 constituting the rotation adapter 7 and the rotational force of the rotor 43 is transmitted to the spiral body 45, FIG. 7 and FIG. In the illustrated rotating adapter 7A, while removing the spring member 46, for example, an inner peripheral surface that is a rotational force transmitting surface of the spiral body 51 formed of silicon rubber, and a rotational force transmitting surface of the rotating body 52 formed of a metal member such as stainless steel. The outer peripheral surface is a contact arrangement.

  Thereby, the outer peripheral surface of the rotating body 52 to be rotated and the inner peripheral surface of the spiral body 51 are integrally configured by a predetermined frictional resistance, so that the external force is not applied to the spiral body 51 or When a force having a value smaller than a predetermined external force is applied, when the rotating body 52 is rotated, the rotating force of the rotating body 52 is transmitted to the spiral body 51, and the spiral body 51 enters a rotating state. .

  The magnitude of the frictional resistance due to surface contact between the inner peripheral surface of the spiral body 51 and the outer peripheral surface of the rotating body 52 is determined by changing the spiral member 51, the members constituting the rotating body 52, changing the combination, or the inner periphery of the spiral body 51. The surface is appropriately adjusted depending on the surface treatment state of each surface which is a contact surface between the surface and the outer peripheral surface of the rotating body 52.

  In the same manner as described above, when an external force of a predetermined magnitude or larger is applied to the spiral 51 from the outside, when the rotating body 52 is rotated, the rotating body 52 is idle with respect to the spiral 51 and there is no load. The non-transmission state due to the load state is entered, and the spiral body 45 enters a rotation stop state. As a result, the same operations and effects as described above can be obtained.

  9 to 11 relate to a second embodiment of the present invention, FIG. 9 is a diagram for explaining another configuration of the rotary adapter, FIG. 10 is a sectional view taken along the line CC of FIG. 9, and FIG. FIG.

  As shown in FIGS. 9 and 10, the rotation adapter 7 </ b> B of the present embodiment has substantially the same configuration as the rotation adapter 7 described in the first embodiment, and includes the outer peripheral surface of the rotating body 43 and the inner periphery of the spiral body 45. While providing a predetermined gap with the surface, the spring member 46 is not disposed in the gap. Accordingly, the spiral body 45 is movable in the radial direction with respect to the rotating body 43. In the state where the rotating body 43 and the spiral body 45 are arranged in the positional relationship shown in the figure, when the arrow direction is the gravity direction, the spiral body 45 is moved in the direction indicated by the arrow, and the upper side in the figure In this state, the rotating body 43 and the spiral body 45 are brought into contact with each other.

  Further, in the rotation adapter 7B, when the inner peripheral surface of the spiral body 45 and the outer peripheral surface of the rotary body 43 are brought into contact with each other with a predetermined pressing force, the rotational force of the rotary body 43 is transmitted to the spiral body 45 by frictional resistance. A combination of members constituting an inner peripheral surface that is a contact surface of the spiral body 45 and an outer peripheral surface that is a contact surface of the rotating body 43, or a contact surface between the inner peripheral surface of the spiral body 45 and the outer peripheral surface of the rotating body 43. The surface treatment state of each surface is set as appropriate.

  In the present embodiment, the insertion portion 21 of the endoscope 2 is operated by hand or the bending portion 25 is bent so that the outer peripheral surface of the spiral body 45 of the rotation adapter 7B is, for example, a predetermined wall on the large intestine wall as shown in FIG. By pressing with the pressing force, the inner peripheral surface of the spiral body 45 comes into surface contact with the outer peripheral surface of the rotating body 43. Then, the rotational force of the rotating body 43 is transmitted to the spiral body 45 by the frictional resistance generated between the inner peripheral surface of the spiral body 45 and the outer peripheral surface of the rotating body 43, and the spiral body 45 rotates as the rotating body 43 rotates. To do.

  Other configurations are the same as those of the first embodiment, and the same members are denoted by the same reference numerals and description thereof is omitted.

  In the endoscope in which the rotation adapter 7B according to the present embodiment is provided at the distal end portion 24, the helical body 45 can be used even when the rotation adapter 7B is disposed in the rotating magnetic field as described with reference to FIGS. Since the inner circumferential surface of the rotating body 43 is simply in contact with the outer circumferential surface of the rotating body 43, the rotational force of the rotating body 43 is not transmitted to the spiral body 45. Therefore, the insertion portion 21 is introduced into the deep portion by a hand operation for bending the bending portion 25 or a twisting operation for twisting the insertion portion 21 without obtaining a propulsive force by the rotation adapter 7B.

  At this time, the surgeon observes the endoscopic image displayed on the display screen 6a of the monitor 6 and confirms the insertion position, the insertion direction, and the like. Therefore, when the surgeon appropriately performs a bending operation or a hand operation and presses the spiral body 45 provided in the rotation adapter 7B provided at the distal end portion 24 as shown in FIG. Is moved relative to the radial direction. Then, the inner peripheral surface of the spiral body 45 and the outer peripheral surface of the rotating body 43 come into contact with each other, and the rotational force of the rotating body 43 is transmitted to the spiral body 45 so that the spiral body 45 is rotated.

  Here, a frictional force is generated when the spiral protrusion 45a provided on the outer peripheral surface of the spiral body 45 is in contact with the large intestine wall, and the frictional force generated at this time causes the insertion portion 21 of the endoscope 2 to move. This is the driving force for introduction toward the deep part of the lumen. Therefore, the surgeon can introduce the insertion portion 21 toward the deep portion by using the propulsive force obtained by the rotation adapter 7.

  Then, while observing the endoscopic image displayed on the display screen 6a of the monitor 6, by appropriately adjusting or changing the contact state between the large intestine and the spiral body 45 of the rotation adapter 7B by the hand operation, the propulsive force The insertion portion 21 can be introduced into the deep portion while switching between the state in which the thrust is generated and the state in which no propulsive force is generated.

  As described above, a predetermined gap is provided between the rotating body and the helical body constituting the rotating adapter, while the outer surface of the rotating body and the inner peripheral surface of the helical body are in surface contact with a predetermined frictional force. By adopting a configuration in which the rotational force is transmitted to the spiral body, the surgeon moves the insertion portion of the endoscope with respect to the radial direction, so that the outer surface of the spiral body of the rotation adapter provided in the insertion portion By appropriately changing the pressing state with the body cavity wall, it is possible to switch between a state in which propulsive force is generated from the rotary adapter and a state in which no propulsive force is generated. Other operations and effects are the same as those in the first embodiment.

FIG. 12 is a view for explaining still another configuration and operation of the rotary adapter according to the third embodiment of the present invention.
As shown in the figure, in the rotation adapter 7C of the present embodiment, the configurations of the rotation adapter 7A, the spiral body 53, and the rotation body 54 are different. Specifically, the rotating body 54 has a flange 54a at one end, and a spiral body holding member 55 is disposed on the inner surface of the flange 54a. Further, the spiral body 53 is configured by the spiral body holding member 55 and the adapter constituting member 47 so that the length dimension of the spiral body 53 moves forward and backward by a predetermined amount with respect to the outer peripheral surface of the rotating body 54 in the longitudinal axis direction. Is set shorter than the width of the space. Therefore, a gap 56 is formed between the adapter constituent member 47 and the spiral body 53 and between the spiral body 53 and the spiral body holding member 55.

  In this embodiment, when the insertion portion 21 of the endoscope 2 is introduced toward the deep portion as indicated by the arrow D, the outer peripheral surface of the spiral body 53 of the rotation adapter 7C is brought into contact with the colon wall. As a result, the spiral body 53 is moved toward the bending portion 25 as indicated by the arrow E, and the proximal end portion of the spiral body 53 is pressed against the spiral body holding member 55. As a result, the base end portion of the spiral body 53 is integrally formed by frictional resistance with the spiral body holding member 55 provided on the flange 54a of the rotary body 54, and the rotational force of the rotary body 54 is transmitted to the spiral body 53. 53 is in a rotating state.

  In the present embodiment, the flange 41a of the main body 41 is disposed on the bending portion 25 side. Further, the outer peripheral surface of the rotating body 54 and the inner peripheral surface of the spiral body 53 have a surface finish in consideration of slidability. Other configurations are the same as those of the above-described embodiment, and the same members are denoted by the same reference numerals and description thereof is omitted.

  In the endoscope in which the rotation adapter 7C of the present embodiment is provided at the distal end portion 24, in the state in which the rotation adapter 7C is disposed in the rotating magnetic field as described with reference to FIGS. 5 and 6, When the gap 56 is formed between the spiral body holding member 55 or simply in contact with the spiral body holding member 55, the rotational force of the rotating body 54 is not transmitted to the spiral body 53. Therefore, the insertion portion 21 is introduced into the deep portion by a hand operation for bending the bending portion 25 or a twisting operation for twisting the insertion portion 21 without obtaining a propulsive force by the rotating adapter 7C.

  At this time, the surgeon observes the endoscopic image displayed on the display screen 6a of the monitor 6 and confirms the insertion position, the insertion direction, and the like. Accordingly, the surgeon appropriately performs a bending operation or a hand operation so that the spiral body 53 provided in the rotation adapter 7C is in contact with the large intestine wall as shown in FIG. By performing, the spiral body 53 is moved to the bending portion 25 side, and the base end portion of the spiral body 53 and the spiral body holding member 55 are integrally disposed by frictional force. Then, the rotational force of the rotating body 54 is transmitted to the spiral body 53, and the spiral body 53 enters a rotating state.

  Here, a frictional force is generated when the spiral protrusion 53a provided on the outer peripheral surface of the spiral body 53 is in contact with the large intestine wall, and the frictional force generated at this time causes the insertion portion 21 of the endoscope 2 to move. This is the driving force for introduction toward the deep part of the lumen. Therefore, the surgeon can introduce the insertion portion 21 toward the deep portion by using the propulsive force obtained by the rotation adapter 7. In addition, by stopping the introduction toward the distal end portion, a gap 56 is formed between the spiral body 53 and the spiral body holding member 55, and the rotation of the spiral body 53 is stopped.

  As described above, the gap is provided between the rotating body and the spiral body constituting the rotary adapter so as to be slidable in the longitudinal direction, while the base end portion of the spiral body is integrated with the flange of the rotating body by the frictional force. By moving the insertion part of the endoscope with respect to the longitudinal axis direction in a state where the outer peripheral surface of the helical body of the rotation adapter is in contact with the body wall by providing the helical body holding member arranged in The rotary adapter provided in the insertion portion can be moved back and forth with respect to the longitudinal axis direction to switch between a state where propulsive force is generated from the rotary adapter and a state where no propulsive force is generated. Other operations and effects are the same as those in the first embodiment.

  FIG. 13 is a diagram illustrating a configuration of an endoscope according to a fourth embodiment of the present invention and a rotary adapter attached to the endoscope.

  The rotation adapter 7 </ b> D in the present embodiment includes a main body 61, a pair of bearings 62, a rotating body 63, a permanent magnet 64 that is a magnetic field generating unit, and a main body end 65.

  The main body 61 has a pipe shape, and a flange 61a is provided at one end. A through-hole 61b in which, for example, the distal end portion 24 of the insertion portion 21 is disposed is formed in the central portion of the main body portion 61 in the longitudinal axis direction.

The bearing portion 62 is fixed to a predetermined position on the outer peripheral surface of the main body portion 61.
The rotating body 63 is disposed on the outer peripheral surface side of the bearing portion 62. Thus, the rotating body 63 is configured to be rotatable with respect to the main body 61.

  The rotating body 63 is formed of, for example, an elastic body having elasticity such as a rubber member, a soft resin member, or a hard resin. The outer surface of the rotating body 63 is provided with a spiral protrusion 63a that is a spiral-shaped portion that generates a propulsive force by rotating and contacting the body wall.

  The permanent magnet 64 is, for example, tubular and is integrally fixed to the inner peripheral surface of the rotating body 63 so as to be positioned between the pair of bearing portions 62. The adapter constituent member 65 has an annular shape and is fixed to the other end side of the main body 61.

  In the rotating adapter 7D, when the formation of the rotating magnetic field by the magnetic induction device 8 is stopped, the rotating body 63 is freely rotated. That is, when the insertion part 21 is introduced toward the deep part in the body cavity, when the rotation adapter 7D comes into contact with the body cavity wall, the rotating body 63 is rotated by the frictional force generated at that time.

  In the present embodiment, a pair of electromagnets 66 and 67 are provided at the distal end portion 24 of the endoscope 2 in order to prevent the rotating body 63 from rotating. The electromagnets 66 and 67 are disposed to face the permanent magnet 64 provided in the rotation adapter 7D. Power cables 66a and 67a extend from the electromagnets 66 and 67. Base ends of the power cables 66a and 67a are connected to the remote switch 29c provided in the operation unit 22, for example. That is, in the present embodiment, the remote switch 29c is a state change switch of the rotation state setting means.

Therefore, a magnetic force is generated from the electromagnets 66 and 67 when the surgeon appropriately operates the remote switch 29c to switch between an energized state for supplying power to the electromagnets 66 and 67 and a non-energized state. Without being rotated, and a rotation stop state in which the rotation of the rotating body 63 is stopped by generating a magnetic force from the electromagnets 66 and 67.
Reference numeral 68 denotes an image pickup apparatus constituting the observation optical system, reference numeral 68a denotes a signal cable extending from the image pickup apparatus, and reference numeral 69 denotes a treatment instrument insertion channel.

  In this way, by switching the energized state at the distal end portion of the endoscope, the rotating body constituting the rotary adapter provided at the distal end portion can be appropriately rotated by arranging the electromagnet that generates magnetic force. The insertion portion can be introduced into the deep body cavity by switching between the state and the rotation stop state.

  This prevents the rotating body of the rotation adapter from rotating due to contact with the body cavity wall when the insertion portion is pushed and pulled.

  In this embodiment, the rotating state of the rotating body is controlled by the electromagnet. However, the rotating body may be switched between a rotatable state and a rotation stopped state by a clutch / brake structure or the like.

  Note that the present invention is not limited to the above-described embodiments, and various modifications can be made without departing from the spirit of the invention.

1 to 8 relate to a first embodiment of the present invention, and FIG. 1 is a diagram for explaining the configuration of an endoscope apparatus. Longitudinal sectional view for explaining the configuration of the rotation adapter AA line sectional view of FIG. The figure explaining the relationship between the external magnetic field produced | generated by the medical magnetic guidance apparatus, and the spiral provided in the rotation adapter The figure which shows the state which has inserted the insertion part of the endoscope into the patient who is lying on the bed part of the medical magnetic guidance device The figure explaining the state which introduces an insertion part with the thrust generated from the rotation adapter provided in the insertion part of an endoscope Longitudinal sectional view for explaining another configuration of the rotation adapter BB sectional view of FIG. 9 to 11 relate to a second embodiment of the present invention, and FIG. 9 is a diagram for explaining another configuration of the rotary adapter. CC sectional view of FIG. Diagram explaining the action of the rotation adapter FIG. 12 is a view for explaining still another configuration and operation of the rotary adapter according to the third embodiment of the present invention. The figure explaining the structure of the endoscope which concerns on 4th Embodiment of this invention, and the rotation adapter with which the endoscope is mounted | worn. The figure explaining the endoscope which provided the rotation adapter in the front-end | tip part of an insertion part The figure explaining the effect | action which rotates a rotation adapter by a rotating magnetic field

Explanation of symbols

DESCRIPTION OF SYMBOLS 7 ... Rotation adapter 24 ... Tip part 41 ... Main body part 43 ... Rotating body 44 ... Permanent magnet 45 ... Spiral body 45a ... Spiral protrusion 46 ... Spring member 46a ... Spring part Agent Patent attorney Susumu Ito

Claims (7)

A main body disposed in the insertion portion of the endoscope;
A rotation holding member fixed to the main body,
A first rotation member rotatably held by the rotation holding member and rotated by an external rotating magnetic field integrally provided with magnetic field generation means;
A second rotating member disposed on the outer peripheral surface side of the first rotating member and provided on the outer peripheral surface with a spiral-shaped portion that imparts a propulsive force to the insertion portion of the endoscope;
A rotational force transmitting means for transmitting the rotational force of the first rotational member to the second rotational member, and in a non-transmission state when a predetermined external force is applied to the second rotational member;
An insertion aid characterized by comprising: The rotational force transmitting means is a biasing member disposed in a gap provided between an outer peripheral surface of the first rotating member and an inner peripheral surface of the second rotating member,
The urging force acting on the inner peripheral surface of the second rotating member of the urging member is set based on a resistance value generated between the second rotating member and the body wall. The insertion assisting tool according to claim 1. A main body disposed in the insertion portion of the endoscope;
A rotation holding member fixed to the main body,
A first rotation member rotatably held by the rotation holding member and rotated by an external rotating magnetic field integrally provided with magnetic field generation means;
An insertion provided with a second rotating member disposed on the outer peripheral surface side of the first rotating member and provided with a spiral-shaped portion on the outer peripheral surface for applying a propulsive force to the insertion portion of the endoscope. In assistive devices,
The rotational force of the first rotating member is transmitted to the second rotating member on the contact surface between the first rotating member and the second rotating member, and a predetermined value is applied to the second rotating member. An insertion assisting device provided with a rotational force transmitting surface that is brought into a non-transmitting state when an external force is applied.   The rotational force transmission surface is a friction surface that generates frictional resistance by contacting the rotating members, and the frictional resistance value of the frictional surface is at least a combination of members constituting each rotating member, or each The insertion assisting tool according to claim 3, wherein the insertion assisting tool is set by a combination of surface treatments applied to the contact surface of the rotating member.   The insertion assist according to claim 3 or 4, wherein an outer peripheral surface of the first rotating member and an inner peripheral surface of the second rotating member are in a non-contact state in a no-load state. Ingredients.   By moving the second rotating member with respect to the radial direction, the inner peripheral surface of the second rotating member comes into contact with the outer peripheral surface of the first rotating member. The insertion assisting tool according to claim 3 or 4.   By moving the second rotating member with respect to the axial direction, a base end surface of the second rotating member comes into contact with a flange provided on the first rotating member. The insertion assisting tool according to claim 3 or 4.

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