JP4997443B2 - Endoscope device - Google Patents

Description

  The present invention relates to an endoscope apparatus, and more particularly to a fetal treatment endoscope apparatus.

  An endoscopic device is used, for example, for observing, examining, or treating the internal organs of a human body.

  The endoscope apparatus includes an optical coupling / separation device, a fiberscope connected to the optical coupling / separation device, a light source device, a therapeutic laser generator, and an information processing device. The fiberscope is composed of a plurality of optical fibers. The light source device is connected to a fiberscope and outputs illumination light to the fiberscope. The fiberscope has a distal end inserted into the human body and a proximal end connected to the optical coupling device and the light source device. When the distal end is inserted into the human body, the fiberscope transmits the reflected light from the observation site to the optical coupling / separation device. The reflected light is converted into an electrical signal by an image sensor provided in the optical coupling / separating device. The electrical signal is transmitted to the information processing apparatus and processed, and then displayed as an image on a monitor included in the information processing apparatus.

  The therapeutic laser generator generates therapeutic laser light and inputs it to the optical coupling / separation device. The optical coupling / separating device outputs a therapeutic laser beam to the fiberscope. The fiberscope transmits a treatment laser beam and irradiates the observation site to treat the observation site.

In order to perform accurate treatment, it is necessary for the user to irradiate the observation site from the distal end of the fiberscope while referring to the image transmitted through the fiberscope. In order to solve this problem, an endoscope system and a laser processing apparatus are known in which an irradiation position can be observed simultaneously with laser irradiation (Patent Documents 1, 2, 3, and 4).
JP 2003-1465 A JP 2005-237436 A Japanese Patent No. 3746554 Japanese Patent No. 3746555

  However, simply confirming the irradiation position with an image has to determine the treatment state based on the user's experience and intuition, and there is no way to confirm that the treatment has been reliably performed. In addition, in order to reliably perform treatment, a therapeutic laser beam more than the necessary amount may be irradiated, which increases the burden on the patient. On the other hand, if the irradiation dose is reduced in order to minimize the irradiation of the therapeutic laser beam, there is a problem that sufficient treatment cannot be performed and re-treatment is required.

  On the other hand, the therapeutic laser light attenuates according to the distance between the distal end of the fiberscope and the observation site. In order to irradiate the therapeutic laser beam with an accurate irradiation amount, it is necessary to estimate the attenuation amount of the therapeutic laser beam. However, since the conventional endoscope system cannot measure the distance between the distal end and the observation site, there is a problem that the attenuation amount of the therapeutic laser beam cannot be estimated.

  Further, the irradiation time of the therapeutic laser light varies depending on the state of the observation site. For this reason, the user has to stop the irradiation of the therapeutic laser beam at any time and check the state of the irradiated part, which causes an additional treatment time and increases the burden on the patient.

  The present invention has been made to solve such a problem, and the conditions of the observation site such as the blood flow of the observation site, the distance from the distal end of the fiberscope to the observation site, and the temperature of the observation site are described. An object of the present invention is to obtain an endoscope apparatus capable of accurately measuring.

  An endoscope apparatus according to the present invention includes an imaging fiber, an illumination fiber, an optical coupling / separation device connected to the imaging fiber, an optical coupling / separation device, and a measuring device connected to the illumination fiber, The imaging fiber transmits the reflected light from the observation site and outputs it to the optical coupling / separation device. The illumination fiber transmits the measurement laser beam input from the measurement device to the observation site, and optical coupling / separation is performed. The apparatus separates reflected light input from the image fiber into an image and reflected laser light, and the measuring apparatus measures the state of the observation site by the reflected laser light input from the optical coupling / separating device. .

  The endoscope apparatus further includes a therapeutic laser apparatus that generates therapeutic laser light and a laser fiber that transmits the therapeutic laser light. The therapeutic laser apparatus transmits the therapeutic laser light to the optical coupling and separating apparatus. Preferably, the optical coupling / separation device outputs the therapeutic laser beam to the laser fiber.

  It is desirable that the measuring device measures the distance from the distal end of the fiberscope to the observation site, or the blood flow or temperature of the observation site using reflected laser light. Safe and reliable laser treatment with less burden on the human body by accurately measuring the blood flow at the observation site, the distance from the distal end of the fiberscope to the observation site, and the temperature of the observation site. Can be obtained.

  The endoscope apparatus further includes an information processing device, the measurement device measures the temperature of the observation site using the reflected laser beam, and outputs a temperature signal indicating the temperature of the observation site to the information processing device. The output of the therapeutic laser beam may be controlled according to the temperature signal.

  The optical coupling / separating device desirably separates the reflected light using a dichroic prism, and the endoscope device may include a light source device that inputs the illumination light to the illumination fiber.

  An optical fiber is provided coaxially with the laser fiber in the radial direction of the laser fiber to form a composite optical fiber, and an illumination fiber is coaxial with the composite optical fiber in the radial direction of the composite optical fiber. It is preferable that the fiberscope is provided.

  It is preferable that the endoscope apparatus further includes a monitor, and the image is displayed on the monitor.

  According to the present invention, an endoscope apparatus capable of accurately measuring the state of an observation site such as the blood flow of the observation site, the distance from the distal end of the fiberscope to the observation site, and the temperature of the observation site. Obtainable.

  Hereinafter, embodiments of an endoscope apparatus according to the present invention will be described with reference to the accompanying drawings.

  An endoscope apparatus according to a first embodiment will be described with reference to FIGS.

  The endoscope apparatus measures a state of an observation site, a fiberscope 100 inserted into a human body, an optical coupling / separation device 200 connected to the fiberscope 100, a treatment laser device 410 that supplies treatment laser light, and the like. Measuring device 300, a light source device 420 including a light source for illuminating an observation site, and an image processing device 430.

  The fiberscope 100 is inserted into the human body from the distal end 101. The distal end 101 faces the observation site. The proximal end 102 is connected to the optical coupling / separating device connecting fiber 110 and the light source device connecting fiber 120 at the proximal end 102 of the fiberscope 100. A measuring device connection fiber 122 branches from the light source device connection fiber 120. These connection fibers are connected to the optical coupling / separation device 200, the light source device 420, and the measurement device 300, respectively.

  The fiberscope 100 includes a composite optical fiber 135 and an illumination fiber 133. The composite optical fiber 135 includes a therapeutic laser fiber 141 that transmits therapeutic laser light to the observation site, and an image fiber 143 that transmits reflected light from the observation site to the optical coupling / separation device 200. The composite optical fiber 135 faces the observation site via the objective lens 131 provided at the distal end 101. The therapeutic laser fiber 141 is located at the center of the cross section of the composite optical fiber 135, and the imaging fiber 143 is composed of a number of fiber elements provided around the therapeutic laser fiber 141. The illumination fiber 133 is arranged in an annular shape, and transmits illumination light from the light source device 420 to the distal end portion 101.

  The light source device 420 provides illumination necessary for observing the observation site. The light source device 420 includes an illumination fiber connection portion 421 and is connected to the light source device connection fiber 120. The illumination light generated by the light source device 420 is transmitted from the illumination fiber connection portion 421 to the illumination fiber 133 through the light source device connection fiber 120.

  The illumination light input to the illumination fiber 133 is transmitted to the distal end 101 of the illumination fiber 133. The illumination light is emitted from the distal end 101 to the observation site.

  The measurement apparatus 300 mainly includes a measurement laser generation apparatus 322 that generates a measurement laser, a laser cut filter 313, and a photodetector 314. The measurement laser generator 322 generates measurement laser light having a wavelength of 780 nm. The measurement laser light is transmitted to the measurement device connection fiber 122 from the measurement device connection fiber connection portion 321 included in the measurement device 300.

  The measurement laser light that has passed through the measurement device connection fiber 122 and the light source device connection fiber 120 is transmitted to the distal end portion 101 of the illumination fiber 133. Then, the measurement laser beam is irradiated from the distal end 101 to the observation site.

  The therapeutic laser device 410 generates therapeutic laser light having a wavelength of 1064 nm. The therapeutic laser beam is a YAG laser beam. The therapeutic laser device 410 is connected to the optical coupling / separation device 200 using a connection fiber 411. The therapeutic laser beam generated by the therapeutic laser device 410 is transmitted to the therapeutic laser device connection unit 213 included in the optical coupling / separation device 200 through the connection fiber 411.

  The optical coupling / separation device 200 has a function of introducing therapeutic laser light into the therapeutic laser fiber 141 and a function of separating reflected light from the observation site transmitted from the imaging fiber 143 into an image and reflected laser light. . The optical coupling / separation device 200 mainly includes first and second dichroic prisms 231 and 241, a laser cut filter 250, a CCD 260, and four lens groups 221, 222, 223, and 224.

  The first and second dichroic prisms 231 and 241 have optical characteristics as shown in FIG. The first dichroic prism 231 has a property of transmitting light having a wavelength of less than 780 nm, and the second dichroic prism 241 has a property of transmitting light having a wavelength of greater than 780 nm. In general, visible light that can be recognized by humans is light having a wavelength of 380 nm to 780 nm. Therefore, the first dichroic prism 231 has an optical characteristic that transmits visible light.

  A therapeutic laser beam having a wavelength of 1064 nm is input from the therapeutic laser device 410 to the therapeutic laser device connection unit 213 included in the optical coupling / separation device 200. The therapeutic laser light is incident on the back surface of the second reflecting surface 242 of the second dichroic prism 241. Light incident on the back surface of the second reflecting surface 242 travels straight without being bent by the second dichroic prism 241. The treatment laser light that travels straight enters the first reflecting surface 232 of the first dichroic prism 231. The therapeutic laser beam is reflected by the first reflecting surface 232, and the optical path is bent toward the first lens group 221. Thereafter, the therapeutic laser light is collected by the first lens group 221 and input to the therapeutic laser fiber 141.

  The therapeutic laser beam input to the therapeutic laser fiber 141 is transmitted to the distal end portion 101 of the therapeutic laser fiber 141. Then, the treatment laser beam is irradiated from the distal end portion 101 to the observation site, and the observation site is treated.

  The observation site is irradiated with illumination light, measurement laser light, and treatment laser light. Therefore, the reflected light from the observation site includes reflected light of illumination light, measurement laser light, and treatment laser light. Reflected light from the observation site enters the distal end 101 of the imaging fiber 143 and is transmitted to the optical coupling / separation device 200.

  The reflected light input to the optical coupling / separating device 200 passes through the first lens group 221 and then enters the first dichroic prism 231. When the reflected light is incident on the first reflecting surface 232, light having a wavelength of 780 nm or less, that is, visible light, of the reflected light is transmitted as an image through the first reflecting surface 232 and guided to the second lens group. Furthermore, the image passes through the laser cut filter 250 and enters the CCD 260 in order to remove the measurement laser beam and the treatment laser beam that have not been reflected by the first dichroic prism 231. The image incident on the CCD 260 is converted into an electric signal and output to the image processing device 430.

  On the other hand, of the reflected light incident on the first reflecting surface 232, light having a wavelength of 780 nm or more is reflected by the first reflecting surface 232. The reflected light is incident on the second reflecting surface 242 of the second dichroic prism 241 as reflected laser light. Since the second reflection surface 242 reflects light having a wavelength of 780 nm or less, the reflected laser light is reflected by the second reflection surface 242 and guided to the measuring device connection unit 212.

  The measuring device 300 receives the reflected laser light from the optical coupling / separation device connecting portion 311. After the reflected laser beam passes through the lens group 312, light having a wavelength other than 780 nm is removed by the laser cut filter 313 and is incident on the photodetector 314. The photodetector 314 outputs a voltage that changes according to the intensity of the reflected laser light as a measurement signal. The measurement signal is transmitted to the image processing device 430 through the measurement signal cable 331.

  The image processing device 430 is connected to the optical coupling / separation device 200 via an image signal cable 431 and to a monitor 440 for displaying an image via a monitor 440 cable 432. The image signal output from the CCD 260 is subjected to various image processing such as dye enhancement processing in the image processing device 430 and displayed on the monitor 440 as an image.

  The measurement signal transmitted from the measurement device 300 through the measurement signal cable 331 is subjected to arithmetic processing by the image processing device 430. By this calculation process, the blood flow and temperature of the observation site and the distance between the distal end 101 of the fiberscope 100 and the observation site are obtained.

  Blood flow can be determined by known methods. For example, an optical heterodyne method obtained using the optical Doppler effect is used. The distance between the distal end 101 of the fiberscope 100 and the observation site can be obtained by a known method. For example, if the temperature of the observation site is constant, the measurement is performed using the property that the intensity of the reflected laser light from the observation site becomes weaker as the distance between the distal end 101 and the observation site increases. The temperature can be determined by known methods. For example, when the distance between the distal end portion 101 and the observation site is constant, the distance is measured using the property that the intensity of the reflected laser light from the observation site increases as the temperature of the observation site increases.

  The obtained blood flow, temperature, and the distance between the distal end 101 and the observation site are displayed on the monitor 440.

  The image processing device 430 is connected to the therapeutic laser device 410 by a control cable 421. The image processing device 430 calculates the remaining irradiation time of the therapeutic laser beam according to the obtained temperature. When the remaining calculation time runs out, the image processing device 430 transmits a signal for stopping the output of the therapeutic laser beam to the therapeutic laser device 410 and stops the irradiation of the therapeutic laser beam.

  Next, the processing of the endoscope apparatus according to the present invention will be described with reference to FIG. 6, for example, using processing for stopping blood flow of blood vessels existing in the placenta of the uterus.

  In step S601, the distal end 101 of the fiberscope 100 is inserted into the uterus. In step S602, a blood vessel whose blood flow should be stopped is searched for with reference to the monitor 440. At this time, the measurement laser is irradiated from the illumination fiber 133, and the distance between the distal end 101 of the fiberscope 100 and the observation site is measured. The monitor 440 displays the distance between the distal end 101 and the observation site. In step S603, the user discovers and determines a blood vessel to be treated. In step S604, the distal end 101 is brought closer to the observation site while referring to the distance between the distal end 101 displayed on the monitor 440 and the observation site. Then, the blood flow at the observation site is measured.

  In step S605, the distal end 101 is placed at a position optimal for irradiation with the therapeutic laser beam. For example, the position is suitable for the focal length of the objective lens 131. In step S606, a treatment laser beam is irradiated to the observation site. During irradiation, the temperature of the observation site is measured using a measurement laser. The output of the therapeutic laser beam is automatically controlled according to the measured temperature. In step S607, it is determined whether or not the observation site has been sufficiently cauterized by the treatment laser beam depending on the temperature. When it is determined that the observation site is sufficient, the irradiation of the treatment laser beam to the observation site is terminated.

  In step S608, it is determined whether the treatment laser beam has been sufficiently irradiated. The determination is made by measuring the blood flow at the observation site. If the blood and blood vessels at the observation site are coagulated by the irradiation of the therapeutic laser beam and the blood flow is stopped, it is determined that the irradiation is sufficient, and the process proceeds to step S609. If the blood flow is not stopped, it is determined that the irradiation is insufficient, and the process proceeds to step S606, where the therapeutic laser beam is irradiated again.

  In step S609, it is determined whether or not irradiation has been performed on all blood vessels that need to be irradiated with therapeutic laser light. If irradiation has been completed for all the blood vessels, the process proceeds to step S610 and the process ends. If not completed, the process moves to step S602 to irradiate another blood vessel with therapeutic laser light.

  Next, processing for controlling the output of the therapeutic laser beam will be described with reference to FIG.

  When the irradiation of the therapeutic laser beam is started, in block 701, the computer, that is, the image processing device 430 estimates the temperature of the observation site using the digital data from the AD converter. Then, the therapeutic laser device 410 is instructed to output the therapeutic laser beam output level according to the estimated temperature. In block 702, the therapeutic laser device 410 irradiates the therapeutic laser light while adjusting the output level in accordance with an instruction from the image processing device 430. In block 703, the irradiation target (observation site) is irradiated with therapeutic laser light.

  On the other hand, in block 704, the blood flow meter (measuring device 300) irradiates the irradiation target with a measurement laser beam having a wavelength of 780 nm. Then, a reflected laser beam having a wavelength of 780 nm is reflected from the irradiation target and enters the blood flow meter. The reflected laser light is guided to a photo detector 314 included in the blood flow meter, and the photo detector 314 outputs a voltage (measurement signal) according to the intensity of the reflected laser light. The voltage is transmitted to an AD converter included in the image processing device 430. In block 705, the voltage (measurement signal) is converted into digital data by the AD converter and transmitted to the image processing device 430.

  Next, a process in which the image processing apparatus 430 displays an image on the monitor 440 will be described with reference to FIG.

  In step S800, when an analog image signal is input from the optical coupling / separation device 200 to the image processing device 430, this processing is executed.

  In step S810, processing necessary for displaying a moving image, such as initialization of a video capture circuit (not shown) in the image processing device 430, is performed in the preprocessing unit.

  Next, in the real-time video display unit 820, processing from step S821 to S823 is performed. In step S <b> 821, the image processing apparatus 430 acquires the resolution of the monitor 440 from the monitor 440. In step S822, the position at which image data is displayed on the monitor 440 is determined according to the resolution of the monitor 440. In step S823, the image processing device 430 performs AD conversion on the image signal continuously input from the CCD 260 by the video capture circuit, and continuously transmits the image data to the monitor 440 and displays it as a moving image. This image data is an image of an observation site that is currently incident on the distal end 101 of the fiberscope 100, and is displayed on the monitor 440 as a real-time moving image by continuously displaying the image data. In step S830, it is determined whether the process is continued. When it is determined that the process is to be continued by a user's button operation or the like, the process is returned to the real-time video display unit 820. If it is determined that the process is to be terminated, the process proceeds to step S840, and the process of displaying an image on the monitor 440 is terminated.

  Accordingly, it is possible to accurately grasp whether the observation site has been sufficiently cauterized, and to reduce the burden on the patient by irradiating the treatment laser light according to the state of the observation site. Further, the user can accurately grasp the distance between the distal end portion 101 and the observation site while searching for the observation site to be treated, and the distal end portion 101 contacts the human body such as the uterus. Can be prevented.

  The second embodiment will be described with reference to FIG. The description of the same configuration as that of the first embodiment is omitted.

  In the second embodiment, the optical coupling / separation device 900 mainly includes a separation device 910 and a coupling device 970.

  The separation device 910 is mainly composed of a first dichroic prism, a laser cut filter 950, and a CCD 960. The reflected light that enters from the optical coupling / separation device connecting fiber 110 enters the first dichroic prism 231. The optical characteristics of the first dichroic prism 231 are the same as those in the first embodiment. The first dichroic prism 231 includes a first reflecting surface 232. Of the reflected light, the reflected laser light having a wavelength of 780 nm is reflected by the first reflecting surface 232 to the coupling device 970. Of the reflected light, light having a wavelength of 780 nm or less, that is, visible light passes through the first reflecting surface 232 as an image. The component of the therapeutic laser beam is removed from the image by the laser cut filter 950 and enters the CCD 960.

  The coupling device 970 is mainly configured by a second dichroic prism. The reflected laser beam output from the separation device 910 is input to the coupling device 970. The reflected laser light input to the coupling device 970 is incident on the second dichroic prism 241. The optical characteristics of the second dichroic prism 241 are the same as those in the first embodiment. The reflected laser light is reflected by the second reflecting surface 242 of the second dichroic prism 241 and guided to the measuring device 300.

  The measuring apparatus 300 uses the reflected laser light input from the coupling apparatus 970 to calculate the blood flow and temperature of the observation site and the distance from the distal end 101 to the observation site using the same means as in the first embodiment. .

  The therapeutic laser device 410 generates therapeutic laser light by the same means as in the first embodiment and outputs it to the coupling device 970. The therapeutic laser beam input to the coupling device 970 is guided to the second dichroic prism 241. Since the therapeutic laser light is incident from the back surface of the second reflecting surface 242 of the second dichroic prism 241, it is transmitted without being reflected by the second reflecting surface 242. Then, the therapeutic laser beam is guided to the separation device 910. The therapeutic laser beam transmitted to the separation device 910 is output to the optical coupling / separation device connecting fiber 110 by the first dichroic prism. The therapeutic laser beam is irradiated to the observation site by the same means as in the first embodiment.

  Thereby, the separation device 910 and the coupling device 970 can be downsized to improve the portability. Further, by connecting the coupling device 970 to the conventional optical coupling / separating device, the same effect as that of the first embodiment can be obtained.

  A third embodiment will be described with reference to FIGS. 10 and 11. The description of the same configuration as that of the first embodiment is omitted.

  The optical coupling / separating device 1100 according to the third embodiment mainly includes first and third dichroic prisms 231 and 1141 and a laser cut filter 1150. The first dichroic prism 231 has the same optical characteristics as in the first embodiment.

  The therapeutic laser beam incident from the therapeutic laser device is reflected by the first reflecting surface 232 of the first dichroic prism 231 and guided to the third dichroic prism 1141. Since the third reflecting surface 1142 of the third dichroic prism 1141 is the surface opposite to the surface on which the therapeutic laser beam is incident, the therapeutic laser beam is transmitted through the third reflecting surface 1142. The therapeutic laser beam is output to the composite optical fiber via the optical coupling / separation device connecting fiber 110, and irradiated to the observation site by the same means as in the first embodiment.

  The reflected light from the observation site is transmitted from the optical coupling / separation device connecting fiber 110 to the optical coupling / separation device via the composite optical fiber. The reflected light incident from the optical coupling / separation device connecting fiber 110 enters the third dichroic prism 1141. The characteristics of the third dichroic prism 1141 are shown in FIG.

  The third dichroic prism 1141 has an optical characteristic of passing only light having a wavelength of 780 nm. Of the reflected light incident on the third reflecting surface 1142 of the third dichroic prism 1141, the reflected laser light having a wavelength of 780 nm is reflected by the third reflecting surface 1142 and guided to the measuring device. Light having a wavelength other than 780 nm passes through the third reflecting surface 1142 as an image and enters the first dichroic prism 231. The first dichroic prism 231 has an optical characteristic of transmitting light having a wavelength of 780 nm or less, that is, visible light. An image having a wavelength of 780 nm or less passes through the first dichroic prism 231 and enters the laser cut filter 1150. The component of the therapeutic laser beam is removed from the image by the laser cut filter, and the image is output to the CCD 1114. The image is converted into an electrical signal by the CCD 1114 and displayed on the monitor by the same means as in the first embodiment.

  The measurement apparatus 300 uses the reflected laser light input from the optical coupling / separation apparatus 1100 to determine the blood flow, temperature, and distance from the distal end 101 to the observation part of the observation part by the same means as in the first embodiment. calculate.

  As a result, the connecting portion of the optical coupling / separation device connecting fiber, the first and third dichroic prisms 231 and 1141, and the CCD can be provided linearly, and the width of the optical coupling / separation device can be reduced. It becomes.

  In the first to third embodiments, the positions of the optical coupling / separation device connection fiber, the therapeutic laser device, the measurement device, and the CCD connected to the optical coupling / separation device may be replaced with each other. At this time, the optical characteristics of each dichroic prism are changed according to the position of each device.

  The optical characteristics of the first to third dichroic prisms may be changed according to the wavelength of the measurement laser beam.

  Furthermore, the optical characteristics of the second and third dichroic prisms only need to transmit the therapeutic laser beam without transmitting the measurement laser beam.

  The measurement of blood flow may not be based on a method that requires specific numerical values, and may be a method that can determine whether there is blood flow.

  The control of the therapeutic laser beam may not be performed automatically. The adjustment of the output of the therapeutic laser beam or the end of irradiation may be recognized by the user by a warning display on the monitor 440 or a warning by sound from the image processing device 430.

It is a block diagram of an endoscope apparatus. It is sectional drawing which showed typically the distal end part periphery of a fiberscope. It is radial direction sectional drawing of a composite optical fiber. It is longitudinal direction sectional drawing of a composite optical fiber. It is the graph which showed the optical characteristic of the 1st and 2nd dichroic prism. It is the flowchart which showed the process in an endoscope apparatus. It is the block diagram shown about irradiation of the laser beam for treatment. 5 is a flowchart illustrating processing for displaying an image on a monitor 440. It is the figure which showed typically the endoscope apparatus in 2nd Embodiment. It is the figure which showed typically the optical coupling separation apparatus in 3rd Embodiment. It is the graph which showed the optical characteristic of the 3rd dichroic prism.

Explanation of symbols

DESCRIPTION OF SYMBOLS 100 Fiberscope 135 Composite optical fiber 133 Illumination fiber 200 1st optical coupling / separation apparatus 231 1st dichroic prism 232 1st reflective surface 232
241 Second dichroic prism 242 Second reflecting surface 242
300 Measurement Device 314 Photodetector 410 Treatment Laser Device 420 Light Source Device 430 Image Processing Device 440 Monitor 440
900 Second optical coupling / separating device 1100 Third optical coupling / separating device

Claims (10)

An image fiber; an illumination fiber; an optical coupling / separation device connected to the image fiber; and a measuring device connected to the optical coupling / separation device and the illumination fiber;
The imaging fiber transmits reflected light from an observation site and outputs the reflected light to the optical coupling / separating device,
The illumination fiber transmits a measurement laser beam input from the measurement device toward an observation site,
The optical coupling / separation device separates the reflected light input from the image fiber into an image and reflected laser light,
The endoscope apparatus, wherein the measuring apparatus measures a state of an observation site by the reflected laser light input from the optical coupling / separating apparatus. The endoscope apparatus further includes a therapeutic laser apparatus that generates therapeutic laser light, and a laser fiber that transmits the therapeutic laser light,
The therapeutic laser device outputs the therapeutic laser light to the optical coupling / separating device,
The endoscope apparatus according to claim 1, wherein the optical coupling / separating device outputs the therapeutic laser light to the laser fiber. The endoscope apparatus according to claim 1, wherein the measurement apparatus measures a distance from a distal end of the illumination fiber to an observation site using the reflected laser light.   The endoscope apparatus according to claim 1, wherein the measurement apparatus measures a blood flow of an observation site using the reflected laser light.   The endoscope apparatus according to claim 1, wherein the measurement apparatus measures a temperature of an observation site using the reflected laser light. The endoscope apparatus further includes an information processing apparatus,
The measuring device measures the temperature of the observation site using the reflected laser light, and outputs a temperature signal indicating the temperature of the observation site to the information processing device,
The endoscope apparatus according to claim 2, wherein the information processing apparatus controls an output of the therapeutic laser light according to the temperature signal.   The endoscope apparatus according to claim 1, wherein the optical coupling / separation device performs separation of the reflected light using a dichroic prism. The endoscope apparatus according to claim 1, characterized in that it comprises a light source device for inputting an irradiation bright light on the illumination fibers. Around the circumference of the laser fiber in the radial direction, the imaging fiber is provided coaxially with the laser fiber to form a composite optical fiber,
The endoscope apparatus according to claim 2 , wherein a fiberscope is configured by providing the illumination fiber coaxially with the composite optical fiber around the composite optical fiber in a radial direction.   The endoscope apparatus according to claim 1, wherein the endoscope apparatus further includes a monitor, and the image is displayed on the monitor.

Images