JP4754740B2 - Endoscope device - Google Patents

Endoscope device Download PDF

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Publication number
JP4754740B2
JP4754740B2 JP2001269097A JP2001269097A JP4754740B2 JP 4754740 B2 JP4754740 B2 JP 4754740B2 JP 2001269097 A JP2001269097 A JP 2001269097A JP 2001269097 A JP2001269097 A JP 2001269097A JP 4754740 B2 JP4754740 B2 JP 4754740B2
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Japan
Prior art keywords
fixture
bending
end side
endoscope
distal end
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JP2001269097A
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Japanese (ja)
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JP2003070717A (en
Inventor
岳志 滝川
秀幸 勢登
祐一 森實
国英 梶
進 青野
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Olympus Corp
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Olympus Corp
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Description

【0001】
【発明の属する技術分野】
本発明は、体内に挿入される挿入部に硬性部が形成された内視鏡装置に関する。
【0002】
【従来の技術】
一般に、硬性鏡と呼ばれる内視鏡は、全体が硬性、すなわち手元の操作部はもとより体内への挿入部も硬性の管にて形成されている。この硬性鏡では手元での操作力が直接的に挿入部先端に伝わる追従性が極めて高く、目的部位に先端部を誘導させ易いという利点がある。
【0003】
また、特公平3−26965号公報には、内視鏡の操作部における挿入部との連結端側の部分に屈曲状態をそのまま維持出来る可撓性構造部分を設け、この可撓性構造部分を変形させることにより、硬性管部として形成されている挿入部の軸線上から外れた方向に内視鏡の操作部のグリップや接眼部を位置させた状態でそのまま維持できるようにした構成が示されている。
【0004】
【発明が解決しようとする課題】
従来から手元の操作部はもとより体内への挿入部も硬性の管にて形成されている硬性鏡を実際の外科手術に使用する現場では、硬性の挿入部を被検者の体内に挿入する方向と、操作部を保持する方向とが異なる場合がある。そのため、硬性鏡を使用中の術者の姿勢が窮屈になる場合があるので、このような場合には術者が被検者の体位、ベッドの高さなどを調節することにより、楽な姿勢で操作できるように工夫する必要がある。しかしながら、被検者の体位、ベッドの高さなどを調節する作業は面倒であるうえ、被検者の体位、ベッドの高さなどを調節するだけでは術者が楽な姿勢で硬性鏡を操作できる程度に硬性鏡の位置を調整することは難しい問題がある。
【0005】
また、このような実状に鑑みて、硬性鏡の持つ利点を損なう事なく、上記欠点を解決する1つの形態として、特公平3−26965号公報のように内視鏡の操作部における挿入部との連結端側の部分に可撓性構造部分を設け、挿入部の軸線上から外れた方向に内視鏡の操作部のグリップや接眼部を位置させた状態でそのまま維持出来る構成が示されている。
【0006】
しかしながら、この方式では、症例中の内視鏡操作などをはじめとした外力が操作部の可撓性構造部に加わった場合には、可撓性構造部分の屈曲状態が確実には維持できず、内視鏡の操作部のグリップや接眼部の位置が予期せぬ方向に動いてしまうおそれがある。
【0007】
本発明は上記事情に着目してなされたもので、その目的は、使用中の術者が楽な姿勢で操作することができ、外力が加わった場合であっても操作部の位置が動いてしまうことを防止して常に安定した姿勢で操作することができる内視鏡装置を提供することにある。
【0008】
【課題を解決するための手段】
請求項1の発明は、細長な挿入部の先端側に観察部位を観察するための対物光学系が設けられるとともに、前記挿入部に硬性部が設けられ、この硬性部の基端部に操作部が配設された内視鏡装置において、
前記硬性部を先端側部分と基端側部分とに分割し、前記先端側部分と基端側部分との間に前記基端側部分に対して前記先端側部分を屈曲可能に連結する関節部を介設するとともに、
前記基端側部分と前記先端側部分との間を固定操作して前記関節部の屈曲状態を保持する固定具を前記関節部に設けたことを特徴とする内視鏡装置である。
そして、本請求項1の発明では、挿入部の硬性部の先端側部分と基端側部分とを関節部を介して屈曲可能に連結し、関節部の固定状態を緩めることにより、基端側部分と先端側部分との間を任意の屈曲角度に自由に調整し、関節部の固定具を固定操作することにより、関節部の屈曲状態を所望の屈曲角度で保持するようにしたものである。
【0009】
請求項2の発明は、前記関節部の周囲を弾性膜で水密的に被覆し、この弾性膜の内側に前記固定具を設け、前記操作部に前記固定具を遠隔操作するレバーを設けたことを特徴とする請求項1に記載の内視鏡装置である。
そして、本請求項2の発明では、関節部の周囲を弾性膜で水密的に被覆し、操作部のレバーによって固定具を遠隔操作することにより、挿入部の硬性部の基端側部分と先端側部分との間を任意の屈曲角度に自由に調整し、関節部の屈曲状態を所望の屈曲角度で保持するようにしたものである。
【0010】
請求項3の発明は、前記関節部の周囲を弾性膜で水密的に被覆し、この弾性膜に前記固定具を貫通・突出させる透孔を設け、この透孔から前記弾性膜の外側に突出させた前記固定具の突出部に前記固定具の操作部を連結するとともに、前記透孔の内周部と前記固定具の操作部とを水密的にシールするシール手段を設けたことを特徴とする請求項に記載の内視鏡装置である。
そして、本請求項3の発明では、弾性膜の透孔から弾性膜の外側に固定具を貫通・突出させ、固定具の突出部に連結させた固定具の操作部を操作することにより、挿入部の硬性部の基端側部分と先端側部分との間を任意の屈曲角度に自由に調整し、かつ関節部の固定具を固定操作することにより、関節部の屈曲状態を所望の屈曲角度で保持する。このとき、シール手段によって透孔の内周部と固定具の操作部との間を水密的にシールするようにしたものである。
【0011】
【発明の実施の形態】
以下、本発明の第1の実施の形態を図1乃至図6を参照して説明する。図1は本実施の形態の内視鏡装置1を示すものである。この内視鏡装置1の内視鏡本体1aには体内に挿入する挿入部2と、この挿入部2の基端部に連結された手元側の操作部3と、この操作部3の手元側面部に一端部が連結された軟性コード4とが設けられている。さらに、挿入部2の基端部と操作部3の先端部との連結部の外側には弾性を有するカバー5が設けられている。
【0012】
また、挿入部2は、細長い硬性部6の先端に湾曲部7が接続されていると共に、この湾曲部7の先端に先端構成部8が接続されて構成されている。さらに、硬性部6は挿入部2の基端側に配置された基端側硬性部(基端側部分)6aと先端側硬性部(先端側部分)6bとに分割され、その間に屈曲部(関節部)9が介設されている。
【0013】
また、内視鏡本体1aの内部には図4に示すように挿入部2から操作部3にわたり、湾曲操作ワイヤ10が挿通されている。ここで、操作部3には、その湾曲操作ワイヤ10を牽引する図示しない湾曲操作機構が組み込まれている。さらに、操作部3には、湾曲操作機構を操作するアングルレバー11が設けられている。そして、アングルレバー11で湾曲操作機構を操作し、湾曲操作ワイヤ10を牽引する事により、湾曲部7の湾曲についての遠隔操作を行うようになっている。
【0014】
また、軟性コード4の先端には、図示しない光源装置やビデオシステムセンターに接続するコネクター12が設けられている。このコネクター12にはライトガイド管13や外部と連通する連通口14などが設けられている。この連通口14は、内視鏡本体1aの内部空間と連通するものである。さらに、連通口14の周縁にはその開口を水密状態で覆う事が出来る図示しない防水キャップを付けるためのキャップ装着部15が形成されている。
【0015】
また、図2は屈曲部9の内部構造を示すものである。ここで、基端側硬性部6aと先端側硬性部6bには、それぞれ金属パイプ17,18が配設されている。さらに、各金属パイプ17,18の端末部には、それぞれにスリーブ17a,18aが設けられている。ここで、先端側硬性部6bの金属パイプ17のスリーブ17aは他の部分よりも小径に形成されている。そして、この金属パイプ17の小径なスリーブ17aの外周面に基端側硬性部6aの金属パイプ18のスリーブ18aが外嵌された状態で嵌着されている。
【0016】
さらに、これらのスリーブ17a,18aが重ね合わされた部分には連通孔19,20がそれぞれ設けられている。そして、この連通孔19,20にはリベット21が嵌め固定されている。
【0017】
また、スリーブ17a,18aにおけるリベット21によって嵌め固定されている固定部の反対側には、同様に屈曲操作用の連通孔22,23が設けられている。そして、この連通孔22,23には固定具24が嵌挿されている。この固定具24の外端部には接着や、連通孔23との嵌合部の形状を四角くすることでスリーブ18aに対して回動しないように固定される固定部24aが形成されている。
【0018】
さらに、固定具24における連通孔22,23内に挿入される部分には雄ねじ部24bがネジ加工されている。この雄ねじ部24bには内側からナット25が螺着されている。また、固定具24の内端部には溝24cが設けられている。この溝24cにはEリング26が取り付けられ、組立後はナット25が雄ねじ部24bから外れないようになっている。
【0019】
さらに、図3に示すように固定具24のナット25の外周面には、鎖車となる歯車27が切られており、この歯車27にはチェーン28が係合されている。このチェーン28の基端部は操作部3側に延出されている。
【0020】
また、操作部3には屈曲部9を屈曲操作するための図示しない屈曲操作レバーが配設されている。そして、チェーン28の基端部はこの操作部3の屈曲操作レバーに取り付られている。これにより、操作部3の屈曲操作レバーの操作によりチェーン28を通じて固定具24のナット25を回転駆動し、スリーブ17a,18aにおける屈曲操作用の連通孔22,23の周壁部間を締め付けたり弛めたりすることができるようになっている。このとき、ナット25を弛めることにより、スリーブ17a,18aにおける屈曲操作用の連通孔22,23の周壁部間を移動可能な状態で保持することで、屈曲部9を所望の角度に屈曲させた状態に調節することができるようになっている。また、逆に屈曲操作レバーの操作によりナット25を締め付けることにより、スリーブ17a,18aにおける屈曲操作用の連通孔22,23の周壁部間を移動不能な状態に固定することで、屈曲部9を所望の調節角度で固定できるようになっている。以上の構成にて硬性部6の片側の基端側硬性部6aと先端側硬性部6bとの間の屈曲部9は屈曲可能になっている。
【0021】
また、屈曲部9の外装は、リング状の弾性部材29で覆われ、その両端は糸30で縛られて水密性が保持されている。さらに、各金属パイプ17,18の外周面には屈曲部9以外の部分が例えば熱収縮チューブのような樹脂31,32で覆われている。
【0022】
また、図4は先端側硬性部6bと湾曲部7との連結部の内部構造を示すものである。ここで、先端側硬性部6bの金属パイプ17の先端部は連結環33と接着固定されている。
【0023】
さらに、この金属パイプ17の先端部と連結環33との接合部には回転方向の強度を補強するために少なくとも1つ以上、本実施の形態では図5に示すように2つのピン34,35が嵌挿され、接着固定されている。ここで、連結環33のピン34,35を嵌挿する位置は、図5に示すように湾曲操作ワイヤ10をガイドするコイル36,37とずらした位置に配置されている。
【0024】
また、連結環33は湾曲部7の基端部に配置された湾曲駒38と接着固定されている。ここで、湾曲駒38の端縁部には後方に向けて図6に示すように一対の凸片39,40が突設されている。さらに、連結環33には湾曲駒38の一対の凸片39,40と対応する位置に切り欠き41,42が形成されている。そして、連結環33の切り欠き41,42と、湾曲駒38の一対の凸片39,40とが係合されて回転方向の回転止め強度を補強するようになっている。
【0025】
次に、上記構成の作用について説明する。本実施の形態の内視鏡装置1では硬性部6の基端側硬性部6aと先端側硬性部6bとの間の屈曲部9を所望の角度に調節する場合には操作部3の屈曲操作レバーを操作する。この屈曲操作レバーの操作時にはチェーン28を通じて固定具24のナット25が回転駆動される。これにより、スリーブ17a,18aにおける屈曲操作用の連通孔22,23の周壁部間を締め付けたり弛めたりするようになっている。
【0026】
このとき、屈曲操作レバーの操作により固定具24のナット25を弛めた場合には、スリーブ17a,18aにおける屈曲操作用の連通孔22,23の周壁部間を移動可能な状態で保持することができる。これにより、屈曲部9を所望の角度に屈曲させた状態に調節することができる。
【0027】
また、逆に屈曲操作レバーの操作により固定具24のナット25を締め付けた場合には、スリーブ17a,18aにおける屈曲操作用の連通孔22,23の周壁部間を移動不能な状態に固定される。これにより、屈曲部9を所望の調節角度で固定できる。
【0028】
そこで、上記構成のものにあっては次の効果を奏する。すなわち、本実施の形態の内視鏡装置1では操作部3の屈曲操作レバーの操作により、固定具24のナット25を弛めることにより、硬性部6の屈曲部9を所望の角度に自由に屈曲させた状態に調節することができる。そのため、使用中の術者が楽な姿勢で内視鏡装置1を操作することができる。
【0029】
さらに、屈曲部9を所望の角度に屈曲させたのち、屈曲操作レバーの操作により固定具24のナット25を締め付けることにより、屈曲部9を所望の角度で確実に維持固定することができる。そのため、症例中の内視鏡操作などをはじめとした外力が内視鏡本体1aの挿入部2に加わっても、硬性部6の屈曲部9が動く事なく常に安定した姿勢で内視鏡の操作ができる効果がある。
【0030】
また、図7は本発明の第2の実施の形態を示すものである。本実施の形態は第1の実施の形態(図1乃至図6参照)の内視鏡装置1の固定具24の構成を次の通り変更したものである。
【0031】
すなわち、本実施の形態では硬性部6の屈曲部9の弾性部材29に固定具挿通用の貫通穴51が形成されている。この貫通穴51は先端側硬性部6bの金属パイプ17のスリーブ17aと、基端側硬性部6aの金属パイプ18のスリーブ18aとの重合部に形成された連通孔22,23と対応する位置に配置されている。そして、本実施の形態の固定具52はこの貫通穴51を通して挿入部2の外部側に突出されている。
【0032】
さらに、本実施の形態の固定具52の内端部には接着や、連通孔22との嵌合部の形状を四角くすることでスリーブ17aに対して回動しないように固定される固定部52aが形成されている。なお、スリーブ17aもしくはスリーブ18aの当接面には摩擦係数が高いコーティングが施されている。
【0033】
また、固定具52における連通孔22,23の外側に突出れる部分には雄ねじ部52bがネジ加工されている。この雄ねじ部52bには外側から固定具操作部53が螺着されて取り付けられている。この固定具操作部53には軸心部に雄ねじ部52bと螺合するねじ穴部53aが形成されている。
【0034】
さらに、固定具操作部53には外端部に術者が手指で操作する大径な操作摘み53bが形成されている。また、固定具52の外端部には固定具操作部53の外側に延出される延出部が形成され、この延出部に溝52cが設けられている。この溝52cにはEリング54が取り付けられ、組立後は雄ねじ部52bから固定具操作部53が外れないようになっている。
【0035】
さらに、弾性部材29には貫通穴51の内部に突起部(シール手段)55が突設されている。そして、この突起部55が固定具52の外周面に圧接されて固定具52との水密を確保するようになっている。なお、これ以外の部分は第1の実施の形態の内視鏡装置1と同一構成になっている。
【0036】
次に、上記構成の作用について説明する。本実施の形態の内視鏡装置1では硬性部6の基端側硬性部6aと先端側硬性部6bとの間の屈曲部9を所望の角度に調節する場合には固定具操作部53の操作摘み53bを回転操作する。この固定具操作部53の回転操作によって第1の実施の形態と同様にスリーブ17a,18aにおける屈曲操作用の連通孔22,23の周壁部間を締め付けたり弛めたりすることで、屈曲部9を所望の角度に調節、固定できる。
【0037】
そこで、本実施の形態では固定具操作部53の回転操作によって、スリーブ17a,18aにおける屈曲操作用の連通孔22,23の周壁部間の締め付けを弛めることにより、第1の実施の形態と同様に硬性部6の屈曲部9を所望の角度に自由に屈曲させた状態に調節することができる。そのため、使用中の術者が楽な姿勢で内視鏡装置1を操作することができる。
【0038】
さらに、屈曲部9を所望の角度に屈曲させたのち、固定具操作部53の回転操作によって、スリーブ17a,18aにおける屈曲操作用の連通孔22,23の周壁部間を締め付けることにより、屈曲部9を所望の角度で確実に維持固定することができる。そのため、症例中の内視鏡操作などをはじめとした外力が内視鏡本体1aの挿入部2に加わっても、硬性部6の屈曲部9が動く事なく常に安定した姿勢で内視鏡の操作ができる効果がある。
【0039】
さらに、本発明は上記実施の形態に限定されるものではなく、本発明の要旨を逸脱しない範囲で種々変形実施できることは勿論である。
次に、本出願の他の特徴的な技術事項を下記の通り付記する。

(付記項1) 観察部位を観察するための対物光学系が細長な挿入部の先端側に設けられ、前記対物光学系の基端側の前記挿入部に関節部を有し、この関節部により基端側挿入部に対して先端側挿入部を屈曲可能とした硬性鏡において、前記関節部の屈曲状態を保持するために前記基端側挿入部と前記先端側挿入部とを固定操作する固定具を前記関節部に設けたことを特徴とする硬性鏡。
【0040】
(付記項2) 付記項1において、前記関節部の周囲を弾性膜で水密的に被覆し、前記固定具を前記弾性膜内側に設け、この固定具を遠隔操作するレバーを操作部に設けたことを特徴とする硬性鏡。
【0041】
(付記項3) 付記項1において、前記関節部の周囲を弾性膜で水密的に被覆し、この弾性膜に前記固定具と前記固定具の操作部を貫通・突出させる透孔を設け、この透孔の内周部と前記固定具の操作部とを水密的に確保するシール手段とを有することを特徴とする硬性鏡。
【0042】
(付記項4) 細長な挿入部に湾曲部と軟性部と湾曲部を操作する湾曲操作ワイヤを有し、湾曲駒と軟性部先端側の連結環を接着およびピンにて固定した内視鏡において、前記連結環のピン位置を前記湾曲操作ワイヤをガイドするコイルを連結環に固定する位置をずらしたことを特徴とする内視鏡。
【0043】
(付記項1〜3の従来技術) 従来、全体が硬性、すなわち手元の操作部はもとより体内への挿入部も硬性の管にて形成された硬性鏡と呼ばれる内視鏡は、手元での操作力が直接的に挿入部先端に伝わる追従性が極めて高く、目的部位に先端部を誘導させ易いという利点があった。しかしながら、実際の現場では、操作部を保持する方向と使用時に挿入する方向が異なる場合があり、術者が被検者の体位、ベッドの高さなどを調節するだけでは楽な姿勢で操作できないという欠点があった。
【0044】
このような実状に鑑みて、硬性鏡の持つ利点を損なう事なく、上記欠点を解決する1つの形態として、特公平3−26965号公報にあるように、挿入部側の操作部側の屈曲状態をそのまま維持出来る可撓性構造となした内視鏡が提案されている。
【0045】
(付記項1〜3が解決しようとする課題) しかしながら、特公平3−26965号公報の方式では、症例中の内視鏡操作などをはじめとした外力が可撓性構造部に加わった場合、可撓性構造部分の屈曲状態が確実には維持出来ないという欠点があった。
【0046】
(付記項1〜3の目的) 本発明は、上記課題に着目してなされたもので、その目的とするところは、基端側挿入部と先端側挿入部の間に関節部と前記関節部を固定する固定具を有し、基端側挿入部と先端側挿入部を所望の角度で屈曲状態を固定出来る内視鏡を提供する事である。
【0047】
(付記項1〜3の効果) 以上説明したように本発明によれば、内視鏡挿入部基端側の屈曲部を所望の角度で確実に維持固定することが可能であり、症例中の内視鏡操作などをはじめとした外力が加わっても、屈曲部が動く事なく常に安定した姿勢で内視鏡の操作ができる。
【0048】
(付記項4の従来技術) 従来の内視鏡は、挿入部の湾曲駒と軟性部先端側の連結環を接着およびピンにて固定していた。
【0049】
(付記項4が解決しようとする課題) 従来の内視鏡では、ピンの位置と湾曲操作ワイヤのガイドコイル固定位置がほぼ一致していたため、組立にてピンを接着する際、接着剤がガイドコイルに付着する可能性が高いという問題があった。
【0050】
(付記項4の目的) 組立作業が確実かつ容易な内視鏡。
【0051】
【発明の効果】
請求項1の発明によれば、挿入部の硬性部の先端側部分と基端側部分とを関節部を介して屈曲可能に連結し、関節部の固定状態を緩めることにより、基端側部分と先端側部分との間を任意の屈曲角度に自由に調整し、関節部の固定具を固定操作することにより、関節部の屈曲状態を所望の屈曲角度で保持するようにしたので、内視鏡挿入部の屈曲部を所望の角度で確実に維持固定することにより、使用中の術者が楽な姿勢で操作することができるとともに、症例中の内視鏡操作などをはじめとした外力が加わっても、屈曲部が動く事なく常に安定した姿勢で内視鏡の操作ができる。
【0052】
請求項2の発明によれば、関節部の周囲を弾性膜で水密的に被覆し、操作部のレバーによって固定具を遠隔操作することにより、挿入部の硬性部の基端側部分と先端側部分との間を任意の屈曲角度に自由に調整し、関節部の屈曲状態を所望の屈曲角度で保持することができる。
【0053】
請求項3の発明によれば、弾性膜の透孔から弾性膜の外側に固定具を貫通・突出させ、固定具の突出部に連結させた固定具の操作部を操作することにより、挿入部の硬性部の基端側部分と先端側部分との間を任意の屈曲角度に自由に調整し、かつ関節部の固定具を固定操作することにより、関節部の屈曲状態を所望の屈曲角度で保持する。このとき、シール手段によって透孔の内周部と固定具の操作部との間を水密的にシールすることができる。
【図面の簡単な説明】
【図1】 本発明の第1の実施の形態の内視鏡装置の外観を示す斜視図。
【図2】 第1の実施の形態の内視鏡装置における挿入部の関節部の内部構造を示す縦断面図。
【図3】 第1の実施の形態の内視鏡装置における関節部の屈曲操作機構を示す要部の平面図。
【図4】 第1の実施の形態の内視鏡装置における挿入部の先端側硬性部と湾曲部との連結部の内部構造を示す縦断面図。
【図5】 図4のV−V線断面図。
【図6】 図4のVI−VI線断面図。
【図7】 本発明の第2の実施の形態の内視鏡装置の要部構成を示す縦断面図。
【符号の説明】
2 挿入部
3 操作部
6 硬性部
6b 先端側硬性部(先端側部分)
6a 基端側硬性部(基端側部分)
9 屈曲部(関節部)
24 固定具
[0001]
BACKGROUND OF THE INVENTION
The present invention relates to an endoscope apparatus in which a hard part is formed in an insertion part to be inserted into a body.
[0002]
[Prior art]
In general, an endoscope called a rigid endoscope is entirely rigid, that is, an insertion portion into a body as well as an operation portion at hand is formed by a rigid tube. This rigid endoscope has an advantage that the operating force at hand is directly transmitted to the distal end of the insertion portion and is extremely easy to guide the distal end portion to the target site.
[0003]
In Japanese Patent Publication No. 3-26965, a flexible structure portion that can maintain a bent state as it is is provided at a portion of the operation portion of the endoscope that is connected to the insertion portion with the insertion portion. Deformation shows a configuration in which the grip of the operation part of the endoscope and the eyepiece part can be maintained as they are in a direction deviating from the axis of the insertion part formed as a rigid tube part. Has been.
[0004]
[Problems to be solved by the invention]
Conventionally, in the field where a rigid endoscope that is formed of a rigid tube as well as an operating part at hand is used for actual surgery, the direction to insert the rigid insertion part into the body of the subject And the direction in which the operation unit is held may be different. Therefore, the posture of the surgeon who is using the rigid endoscope may become cramped. In such a case, the surgeon adjusts the posture of the subject, the height of the bed, etc. It is necessary to devise so that it can be operated with. However, the task of adjusting the patient's posture, bed height, etc. is cumbersome, and the surgeon operates the rigid endoscope in a comfortable posture simply by adjusting the patient's posture, bed height, etc. It is difficult to adjust the position of the rigid endoscope as much as possible.
[0005]
Further, in view of such a situation, as one form for solving the above disadvantages without impairing the advantages of the rigid endoscope, an insertion portion in the operation portion of the endoscope as disclosed in Japanese Patent Publication No. 3-26965. A structure in which a flexible structure portion is provided on the connecting end side portion of the endoscope, and can be maintained as it is with the grip and eyepiece portion of the operation portion of the endoscope positioned in a direction away from the axis of the insertion portion is shown. ing.
[0006]
However, in this method, when an external force such as endoscopic operation in a case is applied to the flexible structure portion of the operation portion, the bending state of the flexible structure portion cannot be reliably maintained. There is a possibility that the grip of the operation part of the endoscope and the position of the eyepiece part may move in an unexpected direction.
[0007]
The present invention has been made paying attention to the above circumstances, and its purpose is that the operator in use can operate in an easy posture, and the position of the operation unit moves even when an external force is applied. It is an object of the present invention to provide an endoscope apparatus that can be operated with a stable posture at all times.
[0008]
[Means for Solving the Problems]
According to the first aspect of the present invention, an objective optical system for observing an observation site is provided on the distal end side of the elongated insertion portion, and a rigid portion is provided in the insertion portion, and an operation portion is provided at a proximal end portion of the rigid portion. In an endoscope apparatus in which
A joint portion that divides the rigid portion into a distal end side portion and a proximal end side portion, and connects the distal end side portion to the proximal end portion so as to be bendable between the distal end side portion and the proximal end side portion. As well as
The endoscope apparatus according to claim 1, wherein a fixing tool that holds the bent state of the joint portion by performing a fixing operation between the base end side portion and the distal end side portion is provided in the joint portion.
In the first aspect of the present invention, the distal end side portion and the proximal end side portion of the rigid portion of the insertion portion are connected so as to be bendable via the joint portion, and the joint portion is loosened so that the proximal end side is loosened. By freely adjusting the angle between the part and the tip side part to an arbitrary bending angle, and fixing the joint part fixture, the bending state of the joint part is held at a desired bending angle. .
[0009]
In the invention of claim 2, the periphery of the joint portion is covered with an elastic membrane in a watertight manner, the fixture is provided inside the elastic membrane, and a lever for remotely operating the fixture is provided in the operation portion. The endoscope apparatus according to claim 1.
And in invention of this Claim 2, the periphery of a joint part is water-tightly covered with an elastic membrane, and the fixing part is remotely operated by the lever of the operation part, whereby the proximal end part and the distal end of the rigid part of the insertion part The space between the side portions is freely adjusted to an arbitrary bending angle, and the bending state of the joint portion is held at a desired bending angle.
[0010]
According to a third aspect of the present invention, the periphery of the joint is covered with an elastic film in a watertight manner, and a through hole is provided in the elastic film so as to penetrate and protrude the fixing tool, and the elastic film protrudes outside the elastic film. A seal means is provided for connecting the operation portion of the fixture to the projecting portion of the fixture and causing the inner peripheral portion of the through hole and the operation portion of the fixture to be watertightly sealed. The endoscope apparatus according to claim 1 .
And in invention of this Claim 3, it inserts by operating the operation part of the fixing tool which penetrated and protruded the fixing tool from the through-hole of the elastic film to the outer side of the elastic film, and was connected with the protrusion part of the fixing tool. Adjust the bending state of the joint part to the desired bending angle by freely adjusting the base part and the tip part of the rigid part of the part to an arbitrary bending angle and fixing the joint fixture. Hold on. At this time, the space between the inner peripheral portion of the through hole and the operation portion of the fixture is sealed in a watertight manner by the sealing means.
[0011]
DETAILED DESCRIPTION OF THE INVENTION
A first embodiment of the present invention will be described below with reference to FIGS. FIG. 1 shows an endoscope apparatus 1 according to the present embodiment. The endoscope main body 1a of the endoscope apparatus 1 includes an insertion portion 2 to be inserted into the body, an operation portion 3 on the proximal side connected to the proximal end portion of the insertion portion 2, and a proximal side surface of the operation portion 3. And a flexible cord 4 having one end connected to the portion. Further, an elastic cover 5 is provided outside the connecting portion between the base end portion of the insertion portion 2 and the distal end portion of the operation portion 3.
[0012]
In addition, the insertion portion 2 is configured such that the bending portion 7 is connected to the distal end of the elongated rigid portion 6 and the distal end constituting portion 8 is connected to the distal end of the bending portion 7. Further, the rigid portion 6 is divided into a proximal end side rigid portion (proximal end portion) 6a and a distal end side rigid portion (distal end portion) 6b disposed on the proximal end side of the insertion portion 2, and a bent portion ( (Joint part) 9 is interposed.
[0013]
Further, as shown in FIG. 4, a bending operation wire 10 is inserted from the insertion section 2 to the operation section 3 inside the endoscope main body 1a. Here, the operation unit 3 incorporates a bending operation mechanism (not shown) that pulls the bending operation wire 10. Further, the operation unit 3 is provided with an angle lever 11 for operating the bending operation mechanism. Then, the bending operation mechanism is operated by the angle lever 11 and the bending operation wire 10 is pulled, whereby the bending operation of the bending portion 7 is remotely controlled.
[0014]
Further, a connector 12 for connecting to a light source device (not shown) or a video system center is provided at the tip of the flexible cord 4. The connector 12 is provided with a light guide tube 13 and a communication port 14 communicating with the outside. The communication port 14 communicates with the internal space of the endoscope body 1a. Further, a cap mounting portion 15 for attaching a waterproof cap (not shown) capable of covering the opening in a watertight state is formed on the periphery of the communication port 14.
[0015]
FIG. 2 shows the internal structure of the bent portion 9. Here, metal pipes 17 and 18 are disposed on the proximal end side rigid portion 6a and the distal end side rigid portion 6b, respectively. Further, sleeves 17a and 18a are provided at the end portions of the metal pipes 17 and 18, respectively. Here, the sleeve 17a of the metal pipe 17 of the distal end side hard part 6b is formed to have a smaller diameter than the other parts. And the sleeve 18a of the metal pipe 18 of the base end side hard part 6a is fitted in the outer peripheral surface of the small diameter sleeve 17a of this metal pipe 17 in the state fitted.
[0016]
Further, communication holes 19 and 20 are provided in the portion where the sleeves 17a and 18a are overlapped. A rivet 21 is fitted and fixed in the communication holes 19 and 20.
[0017]
Further, communication holes 22 and 23 for bending operation are similarly provided on the opposite sides of the fixing portions fixed by the rivets 21 in the sleeves 17a and 18a. A fixing tool 24 is inserted into the communication holes 22 and 23. A fixing portion 24a that is fixed so as not to rotate with respect to the sleeve 18a is formed at the outer end portion of the fixing tool 24 by making the shape of the fitting portion with the bonding or the communication hole 23 square.
[0018]
Further, a male screw portion 24 b is threaded at a portion of the fixture 24 to be inserted into the communication holes 22 and 23. A nut 25 is screwed into the male screw portion 24b from the inside. A groove 24 c is provided at the inner end of the fixture 24. An E-ring 26 is attached to the groove 24c so that the nut 25 does not come off the male screw portion 24b after assembly.
[0019]
Further, as shown in FIG. 3, a gear 27 serving as a chain wheel is cut on the outer peripheral surface of the nut 25 of the fixture 24, and a chain 28 is engaged with the gear 27. The base end portion of the chain 28 extends toward the operation portion 3 side.
[0020]
In addition, a bending operation lever (not shown) for bending the bending portion 9 is disposed in the operation portion 3. The proximal end portion of the chain 28 is attached to the bending operation lever of the operation portion 3. As a result, the nut 25 of the fixture 24 is rotationally driven through the chain 28 by the operation of the bending operation lever of the operation unit 3, and the space between the peripheral walls of the communication holes 22 and 23 for bending operation in the sleeves 17a and 18a is tightened or loosened. You can do that. At this time, the bent portion 9 is bent at a desired angle by loosening the nut 25 and holding the sleeves 17a and 18a between the peripheral walls of the communication holes 22 and 23 for bending operation in a movable state. It can be adjusted to the state. On the other hand, by tightening the nut 25 by operating the bending operation lever, the space between the peripheral walls of the communication holes 22 and 23 for bending operation in the sleeves 17a and 18a is fixed in an immovable state. It can be fixed at a desired adjustment angle. With the above configuration, the bent portion 9 between the proximal end side hard portion 6a and the distal end side hard portion 6b on one side of the hard portion 6 can be bent.
[0021]
Further, the exterior of the bent portion 9 is covered with a ring-shaped elastic member 29, and both ends thereof are bound by a thread 30 to maintain watertightness. Further, the outer peripheral surfaces of the metal pipes 17 and 18 are covered with resin 31 and 32 such as heat shrinkable tubes, for example, other than the bent portion 9.
[0022]
FIG. 4 shows the internal structure of the connecting portion between the distal end side hard portion 6 b and the bending portion 7. Here, the distal end portion of the metal pipe 17 of the distal end side hard portion 6 b is bonded and fixed to the connecting ring 33.
[0023]
Furthermore, at least one or more pins are provided at the joint between the tip of the metal pipe 17 and the connecting ring 33 in order to reinforce the strength in the rotational direction. In this embodiment, as shown in FIG. Is inserted and fixed by adhesion. Here, the positions where the pins 34 and 35 of the connecting ring 33 are inserted are arranged at positions shifted from the coils 36 and 37 that guide the bending operation wire 10 as shown in FIG.
[0024]
Further, the connecting ring 33 is bonded and fixed to a bending piece 38 disposed at the proximal end portion of the bending portion 7. Here, as shown in FIG. 6, a pair of convex pieces 39 and 40 project from the end edge of the bending piece 38 toward the rear. Further, notches 41 and 42 are formed in the connection ring 33 at positions corresponding to the pair of convex pieces 39 and 40 of the bending piece 38. The notches 41 and 42 of the connecting ring 33 and the pair of convex pieces 39 and 40 of the bending piece 38 are engaged to reinforce the rotation stop strength in the rotation direction.
[0025]
Next, the operation of the above configuration will be described. In the endoscope apparatus 1 of the present embodiment, when the bending portion 9 between the proximal end side rigid portion 6a and the distal end side rigid portion 6b of the rigid portion 6 is adjusted to a desired angle, the bending operation of the operation portion 3 is performed. Operate the lever. When the bending operation lever is operated, the nut 25 of the fixture 24 is rotationally driven through the chain 28. As a result, the space between the peripheral walls of the communication holes 22 and 23 for bending operation in the sleeves 17a and 18a is tightened or loosened.
[0026]
At this time, when the nut 25 of the fixture 24 is loosened by operating the bending operation lever, the sleeves 17a and 18a are held in a movable state between the peripheral walls of the bending operation communication holes 22 and 23. Can do. Thereby, the bending part 9 can be adjusted to the state bent to the desired angle.
[0027]
On the other hand, when the nut 25 of the fixing tool 24 is tightened by operating the bending operation lever, the space between the peripheral wall portions of the communication holes 22 and 23 for bending operation in the sleeves 17a and 18a is fixed in an immovable state. . Thereby, the bending part 9 can be fixed at a desired adjustment angle.
[0028]
Therefore, the above configuration has the following effects. That is, in the endoscope apparatus 1 of the present embodiment, the bending portion 9 of the rigid portion 6 is freely bent at a desired angle by loosening the nut 25 of the fixture 24 by operating the bending operation lever of the operation portion 3. Can be adjusted to the state Therefore, the endoscopic device 1 can be operated with a comfortable posture by a surgeon in use.
[0029]
Further, after bending the bent portion 9 to a desired angle, the bent portion 9 can be reliably maintained and fixed at the desired angle by tightening the nut 25 of the fixture 24 by operating the bending operation lever. Therefore, even if an external force such as an endoscope operation in the case is applied to the insertion portion 2 of the endoscope main body 1a, the bending portion 9 of the rigid portion 6 does not move and the endoscope is always in a stable posture. There is an effect that can be operated.
[0030]
FIG. 7 shows a second embodiment of the present invention. In the present embodiment, the configuration of the fixture 24 of the endoscope apparatus 1 according to the first embodiment (see FIGS. 1 to 6) is changed as follows.
[0031]
That is, in this embodiment, a through hole 51 for inserting a fixture is formed in the elastic member 29 of the bent portion 9 of the rigid portion 6. The through hole 51 is located at a position corresponding to the communication holes 22 and 23 formed in the overlapping portion of the sleeve 17a of the metal pipe 17 of the distal end side hard portion 6b and the sleeve 18a of the metal pipe 18 of the proximal end side hard portion 6a. Has been placed. And the fixing tool 52 of this Embodiment is protruded to the exterior side of the insertion part 2 through this through-hole 51. FIG.
[0032]
Further, the fixing portion 52a is fixed to the inner end portion of the fixing member 52 of the present embodiment so as not to rotate with respect to the sleeve 17a by making the shape of the fitting portion with the bonding or the communication hole 22 square. Is formed. The contact surface of the sleeve 17a or the sleeve 18a is coated with a high friction coefficient.
[0033]
A male threaded portion 52b is threaded at a portion of the fixture 52 that protrudes outside the communication holes 22 and 23. A fixing tool operating portion 53 is screwed onto the male screw portion 52b from the outside. The fixture operating portion 53 has a screw hole portion 53a that is screwed into the male screw portion 52b in the axial center portion.
[0034]
Furthermore, a large-diameter operation knob 53b that is operated by a surgeon with fingers is formed at the outer end portion of the fixture operating portion 53. In addition, an extension portion that extends to the outside of the fixture operation portion 53 is formed at the outer end portion of the fixture 52, and a groove 52c is provided in the extension portion. An E ring 54 is attached to the groove 52c so that the fixture operating portion 53 cannot be detached from the male screw portion 52b after assembly.
[0035]
Further, the elastic member 29 is provided with a protrusion (seal means) 55 inside the through hole 51. And this protrusion part 55 is press-contacted to the outer peripheral surface of the fixing tool 52, and water-tightness with the fixing tool 52 is ensured. The other parts have the same configuration as that of the endoscope apparatus 1 according to the first embodiment.
[0036]
Next, the operation of the above configuration will be described. In the endoscope apparatus 1 of the present embodiment, when the bending portion 9 between the proximal end side rigid portion 6a and the distal end side rigid portion 6b of the rigid portion 6 is adjusted to a desired angle, The operation knob 53b is rotated. The bending portion 9 is tightened or loosened by rotating the fixing device operating portion 53 between the peripheral walls of the communicating holes 22 and 23 for bending operation in the sleeves 17a and 18a in the same manner as in the first embodiment. Can be adjusted and fixed to a desired angle.
[0037]
Therefore, in the present embodiment, the tightening between the peripheral wall portions of the communication holes 22 and 23 for bending operation in the sleeves 17a and 18a is loosened by the rotation operation of the fixing tool operation portion 53, thereby being the same as in the first embodiment. In addition, the bent portion 9 of the hard portion 6 can be adjusted to a state where it is freely bent at a desired angle. Therefore, the endoscopic device 1 can be operated with a comfortable posture by a surgeon in use.
[0038]
Further, after bending the bending portion 9 to a desired angle, the bending portion 9 is tightened between the peripheral wall portions of the communication holes 22 and 23 for bending operation in the sleeves 17a and 18a by the rotation operation of the fixture operating portion 53. 9 can be reliably maintained and fixed at a desired angle. Therefore, even if an external force such as an endoscope operation in the case is applied to the insertion portion 2 of the endoscope main body 1a, the bending portion 9 of the rigid portion 6 does not move and the endoscope is always in a stable posture. There is an effect that can be operated.
[0039]
Furthermore, the present invention is not limited to the above-described embodiment, and various modifications can be made without departing from the scope of the present invention.
Next, other characteristic technical matters of the present application are appended as follows.
(Additional Item 1) An objective optical system for observing the observation site is provided at the distal end side of the elongated insertion portion, and the insertion portion on the proximal end side of the objective optical system has a joint portion. In the rigid endoscope in which the distal insertion portion can be bent with respect to the proximal insertion portion, the proximal insertion portion and the distal insertion portion are fixedly operated in order to maintain the bent state of the joint portion. A rigid endoscope characterized in that a fixture is provided at the joint.
[0040]
(Additional Item 2) In Additional Item 1, the periphery of the joint is covered with an elastic membrane in a watertight manner, the fixture is provided inside the elastic membrane, and a lever for remotely operating the fixture is provided in the operation portion. A rigid endoscope characterized by that.
[0041]
(Additional Item 3) In Additional Item 1, the periphery of the joint is covered with an elastic membrane in a watertight manner, and a through hole is provided in the elastic membrane for penetrating and projecting the fixture and the operation portion of the fixture. A rigid endoscope having sealing means for ensuring watertightness of an inner peripheral portion of a through hole and an operation portion of the fixture.
[0042]
(Additional Item 4) In an endoscope having a bending operation wire for operating a bending portion, a flexible portion, and a bending portion in an elongated insertion portion, and a bending piece and a connecting ring on the distal end side of the flexible portion are bonded and fixed by a pin The endoscope is characterized in that the position of fixing the coil for guiding the bending operation wire to the connecting ring is shifted with respect to the pin position of the connecting ring.
[0043]
(Prior Art of Additional Items 1 to 3) Conventionally, an endoscope called a rigid endoscope formed of a rigid tube as a whole, that is, an operation part at hand and a insertion part into the body is also operated at hand. There is an advantage that the followability in which the force is directly transmitted to the distal end of the insertion portion is extremely high, and the distal end portion is easily guided to the target site. However, in the actual site, the direction of holding the operation unit may be different from the direction of insertion during use, and the surgeon cannot operate in an easy posture just by adjusting the subject's position, bed height, etc. There was a drawback.
[0044]
In view of such a situation, as one form for solving the above disadvantages without impairing the advantages of the rigid endoscope, as described in Japanese Examined Patent Publication No. 3-26965, the bending state of the operation portion side on the insertion portion side There has been proposed an endoscope having a flexible structure capable of maintaining the above as it is.
[0045]
(Subjects 1 to 3 to be solved) However, in the method of Japanese Patent Publication No. 3-26965, when an external force such as an endoscope operation in a case is applied to the flexible structure, There is a drawback that the bent state of the flexible structure portion cannot be reliably maintained.
[0046]
(Object of Additional Items 1 to 3) The present invention has been made paying attention to the above-mentioned problem, and the object of the present invention is to provide a joint portion between the proximal-side insertion portion and the distal-side insertion portion and the joint portion. It is intended to provide an endoscope that has a fixing tool for fixing the base end side insertion portion and the distal end side insertion portion at a desired angle.
[0047]
(Effects of Supplementary Items 1 to 3) As described above, according to the present invention, the bending portion on the proximal end side of the endoscope insertion portion can be reliably maintained and fixed at a desired angle. Even when an external force such as an endoscope operation is applied, the endoscope can be operated in a stable posture without moving the bent portion.
[0048]
(Prior Art of Additional Item 4) In a conventional endoscope, the bending piece of the insertion portion and the connecting ring on the distal end side of the soft portion are fixed with an adhesive and a pin.
[0049]
(Problem to be solved by Supplementary Item 4) In the conventional endoscope, the position of the pin and the guide coil fixing position of the bending operation wire are substantially coincided, and therefore, when the pin is bonded in the assembly, the adhesive guides There was a problem of high possibility of adhering to the coil.
[0050]
(Purpose of Supplementary Item 4) Endoscope that is reliable and easy to assemble.
[0051]
【The invention's effect】
According to the first aspect of the present invention, the proximal end portion and the proximal end portion of the rigid portion of the insertion portion are connected to bendable via the joint portion, and the fixed state of the joint portion is loosened. The joint is held at the desired bending angle by freely adjusting the angle between the tip and the tip side part to an arbitrary bending angle, and fixing the joint fixture. By securely maintaining and fixing the bent part of the mirror insertion part at a desired angle, the surgeon in use can be operated in a comfortable posture, and external forces such as endoscopic operation in the case can be performed. Even if added, the endoscope can be operated in a stable posture without moving the bent portion.
[0052]
According to the second aspect of the present invention, the proximal portion and the distal end side of the rigid portion of the insertion portion are covered by watertightly covering the joint portion with the elastic film and remotely operating the fixture by the lever of the operation portion. The part can be freely adjusted to an arbitrary bending angle, and the bending state of the joint can be maintained at a desired bending angle.
[0053]
According to the third aspect of the present invention, the insertion portion is formed by operating the operation portion of the fixing device that is passed through and protrudes from the through hole of the elastic membrane to the outside of the elastic membrane and is connected to the protruding portion of the fixing device. By freely adjusting the angle between the proximal part and the distal part of the rigid part to an arbitrary bending angle and fixing the joint fixing tool, the bending state of the joint part can be adjusted at a desired bending angle. Hold. At this time, the space between the inner peripheral portion of the through hole and the operation portion of the fixture can be sealed in a watertight manner by the sealing means.
[Brief description of the drawings]
FIG. 1 is a perspective view showing an appearance of an endoscope apparatus according to a first embodiment of the present invention.
FIG. 2 is a longitudinal sectional view showing an internal structure of a joint portion of an insertion portion in the endoscope apparatus according to the first embodiment.
FIG. 3 is a plan view of a main part showing a bending operation mechanism of a joint part in the endoscope apparatus according to the first embodiment.
FIG. 4 is a longitudinal sectional view showing an internal structure of a connecting portion between a distal end side hard portion and a bending portion of the insertion portion in the endoscope apparatus according to the first embodiment.
5 is a cross-sectional view taken along line VV in FIG.
6 is a sectional view taken along line VI-VI in FIG. 4;
FIG. 7 is a longitudinal sectional view showing the main configuration of an endoscope apparatus according to a second embodiment of the present invention.
[Explanation of symbols]
2 Insertion part 3 Operation part 6 Hard part 6b Tip side hard part (tip side part)
6a Base end side hard part (base end side part)
9 Bent part (joint part)
24 Fixture

Claims (3)

細長な挿入部の先端側に観察部位を観察するための対物光学系が設けられるとともに、前記挿入部に硬性部が設けられ、この硬性部の基端部に操作部が配設された内視鏡装置において、
前記硬性部を先端側部分と基端側部分とに分割し、前記先端側部分と基端側部分との間に前記基端側部分に対して前記先端側部分を屈曲可能に連結する関節部を介設するとともに、
前記基端側部分と前記先端側部分との間を固定操作して前記関節部の屈曲状態を保持する固定具を前記関節部に設けたことを特徴とする内視鏡装置。
An endoscope in which an objective optical system for observing an observation site is provided on the distal end side of the elongated insertion portion, a hard portion is provided in the insertion portion, and an operation portion is provided at a proximal end portion of the rigid portion. In the mirror device,
A joint portion that divides the rigid portion into a distal end side portion and a proximal end side portion, and connects the distal end side portion to the proximal end portion so as to be bendable between the distal end side portion and the proximal end side portion. As well as
An endoscope apparatus, wherein a fixing tool is provided at the joint part for holding the bent state of the joint part by performing a fixing operation between the base end part and the distal end part.
前記関節部の周囲を弾性膜で水密的に被覆し、この弾性膜の内側に前記固定具を設け、前記操作部に前記固定具を遠隔操作するレバーを設けたことを特徴とする請求項1に記載の内視鏡装置。  The periphery of the joint is covered with an elastic membrane in a watertight manner, the fixture is provided inside the elastic membrane, and a lever for remotely operating the fixture is provided on the operation portion. The endoscope apparatus described in 1. 前記関節部の周囲を弾性膜で水密的に被覆し、この弾性膜に前記固定具を貫通・突出させる透孔を設け、この透孔から前記弾性膜の外側に突出させた前記固定具の突出部に前記固定具の操作部を連結するとともに、前記透孔の内周部と前記固定具の操作部とを水密的にシールするシール手段を設けたことを特徴とする請求項に記載の内視鏡装置。 The periphery of the joint is covered with an elastic membrane in a watertight manner, and a through hole is provided in the elastic membrane for allowing the fixture to penetrate and project, and the projection of the fixture is projected from the through hole to the outside of the elastic membrane. 2. The sealing device according to claim 1 , further comprising a sealing means for sealing the inner peripheral portion of the through hole and the operation portion of the fixture in a watertight manner while connecting the operation portion of the fixture to the portion. Endoscopic device.
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WO2015083526A1 (en) 2013-12-05 2015-06-11 オリンパス株式会社 Method for controlling endoscope and endoscope system

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JP2005006867A (en) * 2003-06-19 2005-01-13 Pentax Corp Endoscope for intraoperative observation
WO2015129086A1 (en) * 2014-02-25 2015-09-03 オリンパス株式会社 Surgical endoscope device

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JPH0716479B2 (en) * 1989-12-28 1995-03-01 富士写真光機株式会社 Endoscopic guide device inserted percutaneously
US5381943A (en) * 1992-10-09 1995-01-17 Ethicon, Inc. Endoscopic surgical stapling instrument with pivotable and rotatable staple cartridge
JP3865489B2 (en) * 1997-11-27 2007-01-10 株式会社町田製作所 Rigid endoscope

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WO2015083526A1 (en) 2013-12-05 2015-06-11 オリンパス株式会社 Method for controlling endoscope and endoscope system
US10441132B2 (en) 2013-12-05 2019-10-15 Olympus Corporation Method of controlling endoscopes, and endoscope system

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