JP5224279B2

JP5224279B2 - Endoscopic magnetic anchor guidance device

Info

Publication number: JP5224279B2
Application number: JP2008177264A
Authority: JP
Inventors: 寿光小林; 直幸内藤; 邦利池田; 晃義松原
Original assignee: Hoya Corp; National Cancer Center Japan
Current assignee: Hoya Corp; National Cancer Center Japan
Priority date: 2008-07-07
Filing date: 2008-07-07
Publication date: 2013-07-03
Anticipated expiration: 2028-07-07
Also published as: JP2010012178A

Description

本発明は、内視鏡観察下で病変部を切除する際に、病変部を把持した把持部材と接続する磁気アンカーを病変部に対して移動させるための内視鏡用磁気アンカー誘導装置に関する。 The present invention relates to an endoscopic magnetic anchor guidance apparatus for moving a magnetic anchor connected to a gripping member that grips a lesioned part with respect to the lesioned part when excising the lesioned part under endoscopic observation.

本出願人は、ベッドに載った患者の体内の対象部位（例えば胃などの臓器）の患部を把持した把持部材に磁性材料からなる磁気アンカーを接続し、患者の体外に配設した磁力発生装置から磁気アンカーに磁力を及ぼすことにより磁気アンカーを移動させる磁気アンカー遠隔誘導システムを提案している（特許文献１）。
磁気アンカーが患部に対して移動すると把持部材によって把持されている患部が磁気アンカー側に持ち上げられるので、処置具によって患部を簡単に切除可能になる。
特開２００４−１０５２４７号公報 The present applicant connects a magnetic anchor made of a magnetic material to a gripping member that grips an affected part of a target site (for example, an organ such as a stomach) in a patient's body placed on a bed and arranges it outside the patient's body. Has proposed a magnetic anchor remote guidance system that moves a magnetic anchor by applying a magnetic force to the magnetic anchor (Patent Document 1).
When the magnetic anchor moves relative to the affected area, the affected area gripped by the gripping member is lifted toward the magnetic anchor, so that the affected area can be easily excised with the treatment tool.
JP 2004-105247 A

しかし、特許文献１では磁力発生装置を体外に配置しているため、磁力発生装置から体内の磁気アンカーまでの距離が長い。そのため、磁力発生装置が大きな磁力を発生可能なものでないと、磁力発生装置で発生した磁力が磁気アンカーに及ばなくなってしまう。
しかし、大きな磁力を発生可能とするためには磁力発生装置を大型化する必要があるので、磁力発生装置の製造コストが高くなってしまう。
さらに、磁気アンカーの吸引方向を変えるためには、患者の体位を変えたり、ベッドを移動させたりする必要があるので、術者や患者の負担が大きかった。 However, in Patent Document 1, since the magnetic force generation device is arranged outside the body, the distance from the magnetic force generation device to the magnetic anchor in the body is long. For this reason, unless the magnetic force generator can generate a large magnetic force, the magnetic force generated by the magnetic force generator does not reach the magnetic anchor.
However, since it is necessary to increase the size of the magnetic force generator in order to generate a large magnetic force, the manufacturing cost of the magnetic force generator increases.
Furthermore, in order to change the suction direction of the magnetic anchor, it is necessary to change the posture of the patient or move the bed, which places a heavy burden on the operator and the patient.

本発明は、小型で安価な磁力発生装置を利用した場合であっても、対象物内部の磁気アンカーに磁力を確実に及ぼすことが可能で、磁気アンカーの吸引制御が容易な内視鏡用磁気アンカー誘導装置を提供することを目的とする。 The present invention is capable of reliably applying a magnetic force to a magnetic anchor inside a target object even when a small and inexpensive magnetic force generator is used, and easily controlling the magnetic anchor's suction. An object is to provide an anchor guide device.

本発明の内視鏡用磁気アンカー誘導装置は、被検者の体腔の内壁を把持する把持部材と接続する磁性材料からなる磁気アンカーに磁力を及ぼすことにより、該磁気アンカーを上記内壁に対して移動させる磁気アンカー誘導装置であって、内視鏡の挿入部が挿通可能で、上記体腔内に挿入可能なオーバーチューブと、該オーバチューブに設けた、上記磁気アンカーを吸引する磁力を発生する磁力発生装置と、を備えることを特徴としている。 The magnetic anchor guiding device for an endoscope of the present invention exerts a magnetic force on a magnetic anchor made of a magnetic material connected to a gripping member that grips an inner wall of a body cavity of a subject , thereby causing the magnetic anchor to move against the inner wall . An apparatus for guiding a magnetic anchor to be moved, wherein an insertion portion of an endoscope can be inserted, an overtube that can be inserted into the body cavity, and a magnetic force that generates a magnetic force for attracting the magnetic anchor provided in the overtube And a generator.

上記磁力発生装置を上記オーバーチューブに固定してもよい。 The magnetic force generator may be fixed to the overtube.

本発明の内視鏡用磁気アンカー誘導装置は、別の態様によると、被検者の体腔の内壁を把持する把持部材と接続する磁性材料からなる磁気アンカーに磁力を及ぼすことにより、該磁気アンカーを上記内壁に対して移動させる磁気アンカー誘導装置であって、上記体腔内に挿入可能な挿入部を有する内視鏡と、上記挿入部に設けた、上記磁気アンカーを吸引する磁力を発生する磁力発生装置と、を備えることを特徴としている。 According to another aspect of the magnetic anchor guiding apparatus for an endoscope of the present invention, the magnetic anchor is configured to exert a magnetic force on a magnetic anchor made of a magnetic material connected to a gripping member that grips an inner wall of a body cavity of a subject. A magnetic anchor guiding device for moving the oscillating member relative to the inner wall , and an endoscope having an insertion portion that can be inserted into the body cavity, and a magnetic force that is provided in the insertion portion and generates a magnetic force for attracting the magnetic anchor And a generator.

この態様では、上記磁力発生装置を上記挿入部に固定してもよい。 In this aspect, the magnetic force generator may be fixed to the insertion portion.

いずれの態様でも、上記磁力発生装置として永久磁石と電磁石のいずれも利用可能であり、永久磁石と電磁石を複数備えていてもよい。 In any aspect, any of a permanent magnet and an electromagnet can be used as the magnetic force generator, and a plurality of permanent magnets and electromagnets may be provided.

オーバーチューブ（請求項１）または内視鏡の挿入部（請求項３）を対象物内部に位置させると磁力発生装置が磁気アンカーに接近する。このように磁力発生装置と磁気アンカーの距離が短ければ、磁力発生装置が発生する磁力が弱くても当該磁力は磁気アンカーに確実に及ぶ。そのため、本発明の内視鏡用磁気アンカー誘導装置は小型で安価な磁力発生装置を利用可能である。
また、磁力発生装置と磁気アンカーの距離が近くなるので、体外に配置した大型の磁力発生装置を用いる場合に比べて磁気アンカーの吸引制御が容易である。
さらに、磁気アンカーを磁力発生装置に吸着させた場合は、磁気アンカーの移動制御をより正確に行うことができる。 When the overtube (Claim 1) or the insertion portion of the endoscope (Claim 3) is positioned inside the object, the magnetic force generator approaches the magnetic anchor. Thus, if the distance between the magnetic force generation device and the magnetic anchor is short, even if the magnetic force generated by the magnetic force generation device is weak, the magnetic force reliably reaches the magnetic anchor. Therefore, the magnetic anchor guiding device for endoscope of the present invention can use a small and inexpensive magnetic force generator.
In addition, since the distance between the magnetic force generation device and the magnetic anchor is reduced, it is easier to control the suction of the magnetic anchor than when a large magnetic force generation device disposed outside the body is used.
Furthermore, when the magnetic anchor is attracted to the magnetic force generator, the movement control of the magnetic anchor can be performed more accurately.

以下、本発明の一実施形態を、図１から図１６を参照しながら詳しく説明する。
図１及び図２には磁気アンカー誘導装置１０Ａが示してある。磁気アンカー誘導装置１０Ａは、ゴム等の弾性材料からなりかつ筒状をなすオーバーチューブ１１の先端部に、両端が開口する筒状をなす永久磁石１２を固定したものである。図２に示すように、オーバーチューブ１１の内周面の先端部には金属製の筒状部材である連結部材１３が嵌合固定してあり、連結部材１３の外周面におけるオーバーチューブ１１の先端から突出した部分に永久磁石１２を嵌合固定している。図示するように、永久磁石１２の両端部の周縁部は面取りしてある。 Hereinafter, an embodiment of the present invention will be described in detail with reference to FIGS.
1 and 2 show a magnetic anchor guide device 10A. The magnetic anchor guide device 10A is formed by fixing a cylindrical permanent magnet 12 made of an elastic material such as rubber and having a cylindrical shape with both ends open to the distal end portion of the cylindrical overtube 11. As shown in FIG. 2, a connecting member 13, which is a metal cylindrical member, is fitted and fixed to the tip of the inner peripheral surface of the overtube 11, and the tip of the overtube 11 on the outer peripheral surface of the connecting member 13. The permanent magnet 12 is fitted and fixed to the portion protruding from the head. As shown in the drawing, the peripheral edge portions of both end portions of the permanent magnet 12 are chamfered.

図３は磁気アンカー誘導装置１０Ａの内部を挿通可能な内視鏡２０を示している。
内視鏡２０は、術者が把持する操作部２１と、操作部２１から延びる挿入部２２と、操作部２１から挿入部２２と反対側に向かって延び、端部にプロセッサ（光源装置兼画像処理装置。図示略）に接続するためのコネクタ部２４を有するユニバーサルチューブ２３と、を具備している。図８、図９等に示すように、挿入部２２の先端面２５には、操作部２１及び挿入部２２の内部に設けた処置具挿通路２６の出口開口２７が設けてある。さらに先端面２５には、一対の照明レンズと、直後（挿入部２２の先端部内）に対物レンズと撮像素子（共に図示略）が位置する観察窓と、エア及び洗浄水を送るための送気送水孔と、が設けてある。処置具挿通路２６の基端側開口部は、操作部２１に突設した処置具挿通用突部２８の端面に形成してあり、処置具挿通用突部２８にはスリットを形成したゴムキャップ２９が被せてある。 FIG. 3 shows an endoscope 20 that can be inserted through the magnetic anchor guide device 10A.
The endoscope 20 has an operation unit 21 held by an operator, an insertion unit 22 extending from the operation unit 21, and extends from the operation unit 21 toward the opposite side of the insertion unit 22, and has a processor (light source device / image) at the end. And a universal tube 23 having a connector portion 24 for connection to a processing apparatus (not shown). As shown in FIGS. 8 and 9, the distal end surface 25 of the insertion portion 22 is provided with an operation portion 21 and an outlet opening 27 of a treatment instrument insertion passage 26 provided inside the insertion portion 22. Furthermore, on the distal end surface 25, a pair of illumination lenses, an observation window in which an objective lens and an image pickup device (both not shown) are located immediately after (in the distal end portion of the insertion portion 22), and air supply for sending air and cleaning water And a water supply hole. The proximal end side opening of the treatment instrument insertion passage 26 is formed on the end face of the treatment instrument insertion protrusion 28 protruding from the operation section 21, and the treatment instrument insertion protrusion 28 has a rubber cap formed with a slit. 29 is covered.

図４及び図５には、永久磁石１２によって移動制御（吸引）可能な磁気アンカー３０と、連結ひも（連結部材）３５を介して磁気アンカー３０に接続した把持装置（把持部材４０、ループワイヤ４９、収納筒部材５０）と、が図示してある。
略三角錐形状をなす磁気アンカー３０は強磁性体（例えば、純鉄、鉄合金のほか、プラチナマグネット、希土類磁石、テルビウム・ディスプロシウム・鉄合金などの磁石）からなるものである。磁気アンカー３０の端部には、柔軟性を有しかつ全体として環状をなす連結ひも３５の一部が接続（固定）してある。連結ひも３５としては、例えば、手術用縫合糸、釣糸、金属製ワイヤを利用可能である。さらに、この連結ひも３５には金属等の弾性材料からなる把持部材４０が接続してある。
把持部材４０は一対の開閉片４１を具備している。一対の開閉片４１は共に、略平行な基端部４２と、基端部４２に連なる中間部４３と、中間部４３に連なる先端把持部４４と、を具備している。中間部４３における基端部４２に連なる部分は第１傾斜部４５となっており、先端把持部４４における中間部４３に連なる部分は第２傾斜部４６となっている。さらに、両先端把持部４４の先端には互いに対向する把持爪４７が設けてある。なお、把持部材４０を３枚以上の開閉片４１から構成することも可能である。
図示するように、把持部材４０の一対の開閉片４１の間の隙間には、全体として環状をなしかつ可撓性を有する金属製のループワイヤ４９が通してある。このループワイヤ４９は、所定の切断力以上の強い力で牽引したときに切断するものである。 4 and 5, a magnetic anchor 30 that can be moved (sucked) by the permanent magnet 12 and a gripping device (a gripping member 40, a loop wire 49) connected to the magnetic anchor 30 via a connecting string (connecting member) 35. , Storage cylinder member 50).
The magnetic anchor 30 having a substantially triangular pyramid shape is made of a ferromagnetic material (for example, a magnet such as platinum magnet, rare earth magnet, terbium / dysprosium / iron alloy in addition to pure iron or iron alloy). A part of a connecting string 35 that is flexible and has an annular shape as a whole is connected (fixed) to the end of the magnetic anchor 30. As the connecting string 35, for example, a surgical suture, a fishing line, and a metal wire can be used. Further, a gripping member 40 made of an elastic material such as metal is connected to the connecting string 35.
The gripping member 40 includes a pair of opening / closing pieces 41. Each of the pair of opening / closing pieces 41 includes a base end portion 42 that is substantially parallel, an intermediate portion 43 that is continuous with the base end portion 42, and a tip gripping portion 44 that is continuous with the intermediate portion 43. A portion of the intermediate portion 43 that is continuous with the base end portion 42 is a first inclined portion 45, and a portion of the distal end gripping portion 44 that is continuous with the intermediate portion 43 is a second inclined portion 46. Further, gripping claws 47 that face each other are provided at the tips of both tip gripping portions 44. The gripping member 40 can be composed of three or more open / close pieces 41.
As shown in the drawing, a metal loop wire 49 having a ring shape and flexibility is passed through the gap between the pair of opening and closing pieces 41 of the gripping member 40. The loop wire 49 is to be cut when it is pulled with a strong force exceeding a predetermined cutting force.

収納筒部材５０は連結ひも３５、把持部材４０及びループワイヤ４９の一部を収納するための部材であり、両端が開口する円筒形をなしている。収納筒部材５０は大径部５１と小径部５２を具備している。大径部５１側の開口縁部はテーパ面５３となっており、大径部５１と小径部５２に跨る部分には一本のスリット５４が設けてある。さらに、収納筒部材５０の内部孔５５の内径はその全長にわたって一定である。この収納筒部材５０は、例えばステンレスやプラスチックや超弾性合金により成形することができる。
磁気アンカー３０と一体化した連結ひも３５にループワイヤ４９及び収納筒部材５０を接続して一体化するには、まずスリット５４を利用して磁気アンカー３０と一体化した連結ひも３５を収納筒部材５０の内部に通し、テーパ面５３の内側を通して収納筒部材５０の外部に引き出す。そして、ループワイヤ４９と一体化させた把持部材４０の一対の開閉片４１（把持爪４７）の隙間に連結ひも３５を通し、さらに収納筒部材５０の小径部５２側の端面開口部から紐あるいは先端にフック部を備える硬質部材からなる棒を挿入し、紐あるいはフック部を収納筒部材５０のテーパ面５３側の開口部から突出させる。そして最後に、この紐あるいはフック部をループワイヤ４９に引っ掛け、紐あるいは棒を小径部５２側の端面方向に引っ張る。すると、図４及び図５に示すように、磁気アンカー３０、連結ひも３５、ループワイヤ４９及び収納筒部材５０が一体化する。 The storage cylinder member 50 is a member for storing a part of the connecting string 35, the gripping member 40, and the loop wire 49, and has a cylindrical shape with both ends open. The storage cylinder member 50 includes a large diameter part 51 and a small diameter part 52. The opening edge on the large diameter portion 51 side is a tapered surface 53, and a single slit 54 is provided in a portion straddling the large diameter portion 51 and the small diameter portion 52. Further, the inner diameter of the inner hole 55 of the storage cylinder member 50 is constant over its entire length. The storage cylinder member 50 can be formed of, for example, stainless steel, plastic, or a superelastic alloy.
In order to connect and integrate the loop wire 49 and the storage cylinder member 50 to the connection string 35 integrated with the magnetic anchor 30, first, the connection string 35 integrated with the magnetic anchor 30 using the slit 54 is stored in the storage cylinder member. 50 is pulled out through the inside of the tapered surface 53 to the outside of the storage cylinder member 50. Then, the connecting cord 35 is passed through the gap between the pair of opening / closing pieces 41 (gripping claws 47) of the gripping member 40 integrated with the loop wire 49, and further, the string or the string from the end opening on the small diameter portion 52 side of the storage cylinder member 50 A rod made of a hard member having a hook portion at the tip is inserted, and the string or the hook portion is projected from the opening on the tapered surface 53 side of the storage cylinder member 50. Finally, the string or hook part is hooked on the loop wire 49, and the string or bar is pulled in the direction of the end face on the small diameter part 52 side. Then, as shown in FIGS. 4 and 5, the magnetic anchor 30, the connecting string 35, the loop wire 49, and the storage cylinder member 50 are integrated.

このようにして一体化した磁気アンカー３０、連結ひも３５、ループワイヤ４９及び収納筒部材５０が図４及び図５に示す状態にあるとき、把持部材４０は一対の把持爪４７が互いに接触する全閉状態となる。
この状態からループワイヤ４９を把持爪４７と反対方向に上記切断力より小さい力で引くと、図６に示すように、把持部材４０の一対の第１傾斜部４５がテーパ面５３に接触することにより互いに近づく方向に弾性変形し、一対の中間部４３が内部孔５５内に収納される。すると、一対の中間部４３が内部孔５５の周面に接触することにより互いに近づく方向に弾性変形するので、この動きに連動して一対の先端把持部４４が開き、把持部材４０は図６に示す全開状態となる。
この状態からループワイヤ４９を上記切断力より小さい力でさらに引くと、図７に示すように把持部材４０の一対の第２傾斜部４６が収納筒部材５０の内部に引き込まれる。第２傾斜部４６がテーパ面５３に接触することにより互いに近づく方向に弾性変形すると、図７に示すように一対の把持爪４７が互いに接近するので、把持部材４０は再度全閉状態となる。 When the magnetic anchor 30, the connecting cord 35, the loop wire 49, and the storage cylinder member 50 integrated in this way are in the state shown in FIGS. 4 and 5, the gripping member 40 is the whole of the pair of gripping claws 47 in contact with each other. Closed.
When the loop wire 49 is pulled with a force smaller than the cutting force in the opposite direction to the gripping claws 47 from this state, the pair of first inclined portions 45 of the gripping member 40 come into contact with the tapered surface 53 as shown in FIG. Therefore, the pair of intermediate portions 43 are accommodated in the inner hole 55. Then, since the pair of intermediate portions 43 are elastically deformed in the direction approaching each other by contacting the peripheral surface of the inner hole 55, the pair of tip gripping portions 44 are opened in conjunction with this movement, and the gripping member 40 is shown in FIG. It will be in the fully open state shown.
When the loop wire 49 is further pulled with a force smaller than the cutting force from this state, the pair of second inclined portions 46 of the gripping member 40 are pulled into the storage cylinder member 50 as shown in FIG. When the second inclined portion 46 comes into contact with the tapered surface 53 and is elastically deformed in a direction approaching each other, the pair of gripping claws 47 approach each other as shown in FIG. 7, so that the gripping member 40 is again fully closed.

図９等に示した操作装置６０は、ゴムキャップ２９のスリット及び内視鏡２０の処置具挿通用突部２８から処置具挿通路２６の内部に挿入するものであり、挿入管６１、挿入コイル６２、規制管６３及び操作ワイヤ６９を具備している。
挿入管６１は可撓性を有する筒状部材であり、挿入コイル６２は挿入管６１の内部に相対移動可能に挿入してある。規制管６３は前部をなす大径部６４と、後部をなしかつ挿入コイル６２の先端部に嵌合固定される小径部６５と、を備えている。大径部６４の外径は挿入管６１の内径より小さく、かつ、挿入コイル６２の外径とほぼ同一に設定してある。さらに、大径部６４の内径は小径部６５の内径及び収納筒部材５０の小径部５２の外径より大きく設定してあり、大径部６４の内周面と小径部６５の内周面の接続部には環状段部６６が形成してある。
挿入コイル６２の内側には、先端にフック部材６８を固定した操作ワイヤ６９が相対移動可能に配設してある。さらに、挿入管６１、挿入コイル６２及び操作ワイヤ６９の各基端部は、図示を省略した基端側操作部によって互いに軸方向に相対移動可能として結合してある。 The operation device 60 shown in FIG. 9 or the like is inserted into the treatment instrument insertion passage 26 from the slit of the rubber cap 29 and the treatment instrument insertion protrusion 28 of the endoscope 20, and includes an insertion tube 61, an insertion coil, and the like. 62, a restriction tube 63, and an operation wire 69 are provided.
The insertion tube 61 is a flexible cylindrical member, and the insertion coil 62 is inserted into the insertion tube 61 so as to be relatively movable. The restriction tube 63 includes a large-diameter portion 64 that forms the front portion, and a small-diameter portion 65 that forms the rear portion and is fitted and fixed to the distal end portion of the insertion coil 62. The outer diameter of the large diameter portion 64 is set smaller than the inner diameter of the insertion tube 61 and substantially the same as the outer diameter of the insertion coil 62. Further, the inner diameter of the large-diameter portion 64 is set to be larger than the inner diameter of the small-diameter portion 65 and the outer diameter of the small-diameter portion 52 of the storage cylinder member 50, and the inner peripheral surface of the large-diameter portion 64 and the inner peripheral surface of the small-diameter portion 65 are set. An annular step 66 is formed at the connecting portion.
Inside the insertion coil 62, an operation wire 69 having a hook member 68 fixed to the tip is disposed so as to be relatively movable. Further, the base end portions of the insertion tube 61, the insertion coil 62, and the operation wire 69 are coupled to each other so as to be relatively movable in the axial direction by a base end side operation portion (not shown).

次に、患者の病変部Ｘの切除要領について説明する。
まず、局所麻酔を施した患者をベッド上に横たわらせ、患者の口から内視鏡２０の挿入部２２を挿入し、挿入部２２を臓器Ｂ内に位置させる（図８等を参照）。次いで、内視鏡２０の処置具挿通用突部２８から、先端部に注射針を具備するチューブ状の処置具（図示略）を挿入し、その注射針を挿入部２２の出口開口２７から突出させる。そして、注射針を病変部Ｘの周辺から臓器壁の粘膜下層に挿入して生理食塩水を注入し、病変部Ｘを固有筋層から浮き上がらせておく（図８等を参照）。 Next, a procedure for excision of a lesion X of a patient will be described.
First, a patient who has undergone local anesthesia is laid on a bed, and the insertion portion 22 of the endoscope 20 is inserted from the mouth of the patient, and the insertion portion 22 is positioned in the organ B (see FIG. 8 and the like). . Next, a tube-like treatment tool (not shown) having an injection needle is inserted into the distal end portion from the treatment tool insertion protrusion 28 of the endoscope 20, and the injection needle protrudes from the outlet opening 27 of the insertion portion 22. Let Then, an injection needle is inserted from the periphery of the lesioned part X into the submucosal layer of the organ wall and physiological saline is injected, and the lesioned part X is lifted from the proper muscle layer (see FIG. 8 and the like).

次いで、内視鏡２０を患者の体外に引き出し、磁気アンカー誘導装置１０Ａの内部に内視鏡２０の挿入部２２を挿入し、挿入部２２の手元側に磁気アンカー誘導装置１０Ａを装着する。さらに、内視鏡２０に対して、一体化した磁気アンカー３０、把持部材４０、ループワイヤ４９及び収納筒部材５０を次の手順で取り付ける。
まず、図９に示すように、内視鏡２０の処置具挿通路２６に操作装置６０を挿通し、挿入管６１の先端部を挿入部２２の出口開口２７から外部に僅かに突出させ、さらに規制管６３の先端部を挿入管６１の先端部から僅かに突出させる。次いで、上記基端側操作部を操作することにより操作ワイヤ６９の先端部に固着したフック部材６８を規制管６３の前方に突出させる。
次いで、フック部材６８の直前にループワイヤ４９を位置させ、フック部材６８をループワイヤ４９に引っ掛ける。そして、上記基端側操作部を操作することによりフック部材６８を操作ワイヤ６９の基端側に引っ張る。すると把持部材４０の一対の第１傾斜部４５が収納筒部材５０のテーパ面５３に接触するので、操作ワイヤ６９の牽引力が収納筒部材５０に及び、収納筒部材５０の小径部５２が環状段部６６に当接するまで大径部６４の内部に引き込まれる（図１０参照）。このようにして規制管６３の内部に小径部５２を収納しても、収納筒部材５０のスリット５４の前端部は規制管６３の大径部６４より前方に位置するので（図１０等参照）、連結ひも３５をスリット５４の前端部から外部へ引き出すことができる。
続いて、上記基端側操作部を操作することにより挿入コイル６２及び操作ワイヤ６９を基端側に引くと、図１１に示すように把持部材４０及び収納筒部材５０が挿入管６１の内部に引き込まれ、かつ磁気アンカー３０の端部が挿入管６１の先端部に嵌合する。
そして、最後に上記基端側操作部を操作することにより挿入管６１、挿入コイル６２及び操作ワイヤ６９を基端側に引くと、図１１に示すように磁気アンカー３０が処置具挿通路２６の出口開口２７に嵌合するので、磁気アンカー３０、把持部材４０、ループワイヤ４９及び収納筒部材５０からなる一体物と、操作装置６０とが内視鏡２０と一体になる。 Next, the endoscope 20 is pulled out of the patient's body, the insertion portion 22 of the endoscope 20 is inserted into the magnetic anchor guidance device 10 </ b> A, and the magnetic anchor guidance device 10 </ b> A is attached to the proximal side of the insertion portion 22. Further, the integrated magnetic anchor 30, gripping member 40, loop wire 49 and storage cylinder member 50 are attached to the endoscope 20 in the following procedure.
First, as shown in FIG. 9, the operating device 60 is inserted into the treatment instrument insertion path 26 of the endoscope 20, the distal end portion of the insertion tube 61 is slightly protruded from the outlet opening 27 of the insertion portion 22, and The distal end portion of the restriction tube 63 is slightly projected from the distal end portion of the insertion tube 61. Next, the hook member 68 fixed to the distal end portion of the operation wire 69 is caused to protrude forward of the restriction tube 63 by operating the proximal end side operation portion.
Next, the loop wire 49 is positioned immediately before the hook member 68, and the hook member 68 is hooked on the loop wire 49. Then, the hook member 68 is pulled toward the proximal end side of the operation wire 69 by operating the proximal end side operation portion. Then, the pair of first inclined portions 45 of the gripping member 40 come into contact with the tapered surface 53 of the storage cylinder member 50, so that the traction force of the operation wire 69 reaches the storage cylinder member 50, and the small diameter portion 52 of the storage cylinder member 50 is an annular step. It is drawn into the large diameter portion 64 until it abuts on the portion 66 (see FIG. 10). Even if the small-diameter portion 52 is housed inside the regulation tube 63 in this way, the front end portion of the slit 54 of the housing cylinder member 50 is located in front of the large-diameter portion 64 of the regulation tube 63 (see FIG. 10 and the like). The connecting cord 35 can be pulled out from the front end of the slit 54.
Subsequently, when the insertion coil 62 and the operation wire 69 are pulled toward the proximal end by operating the proximal end side operation portion, the gripping member 40 and the storage cylinder member 50 are brought into the insertion tube 61 as shown in FIG. The end of the magnetic anchor 30 is engaged with the distal end of the insertion tube 61.
Finally, when the insertion tube 61, the insertion coil 62, and the operation wire 69 are pulled toward the proximal end by operating the proximal end operation portion, the magnetic anchor 30 is moved into the treatment instrument insertion passage 26 as shown in FIG. Since the fitting is made in the outlet opening 27, the integrated body composed of the magnetic anchor 30, the gripping member 40, the loop wire 49 and the storage cylinder member 50 and the operation device 60 are integrated with the endoscope 20.

次いで、挿入部２２の先端部及び磁気アンカー３０を臓器Ｂ内に挿入し、さらに磁気アンカー誘導装置１０Ａを挿入部２２に対してスライドさせて臓器Ｂ内に位置させる。そして、図１２に示すように挿入部２２の先端部を臓器Ｂに接近させた後に操作装置６０を先端側方向に移動させて、磁気アンカー３０、連結ひも３５、把持部材４０、ループワイヤ４９、及び収納筒部材５０を内視鏡２０から離間させる。さらに、挿入コイル６２と操作ワイヤ６９を操作することによって規制管６３と共に収納筒部材５０を挿入管６１に対して先端側に相対移動させると、この動作にともなって把持部材４０が収納筒部材５０と一緒に先端側に移動するので、把持部材４０の先端（把持爪４７）が磁気アンカー３０の端面に当接する。収納筒部材５０をさらに移動させると、挿入管６１の先端部に嵌合している磁気アンカー３０が把持部材４０（把持爪４７）によって押し出され（挿入管６１から外れ）、かつ収納筒部材５０が挿入管６１の先端から突出する（図１２参照）。挿入管６１から外れた磁気アンカー３０には永久磁石１２の磁力が及ぶので、図１２に示すように磁気アンカー３０は永久磁石１２側に吸引される。 Next, the distal end portion of the insertion portion 22 and the magnetic anchor 30 are inserted into the organ B, and the magnetic anchor guide device 10A is slid with respect to the insertion portion 22 and positioned in the organ B. Then, as shown in FIG. 12, after the distal end portion of the insertion portion 22 is brought close to the organ B, the operating device 60 is moved in the distal direction, so that the magnetic anchor 30, the connecting cord 35, the gripping member 40, the loop wire 49, And the storage cylinder member 50 is separated from the endoscope 20. Further, when the storage tube member 50 is moved relative to the insertion tube 61 together with the restriction tube 63 by operating the insertion coil 62 and the operation wire 69, the gripping member 40 is moved to the storage tube member 50 along with this operation. The tip of the gripping member 40 (the gripping claw 47) comes into contact with the end surface of the magnetic anchor 30. When the storage cylinder member 50 is further moved, the magnetic anchor 30 fitted to the distal end portion of the insertion tube 61 is pushed out (disengaged from the insertion tube 61) by the grip member 40 (the grip claw 47), and the storage cylinder member 50 Protrudes from the tip of the insertion tube 61 (see FIG. 12). Since the magnetic force of the permanent magnet 12 reaches the magnetic anchor 30 that is removed from the insertion tube 61, the magnetic anchor 30 is attracted toward the permanent magnet 12 as shown in FIG.

次いで、（上記切断力より小さい力で）操作ワイヤ６９を基端側に引っ張ると、ループワイヤ４９及び把持部材４０が収納筒部材５０に対して操作ワイヤ６９の基端側に相対移動するので、図６に示すように把持部材４０の一対の開閉片４１が全開状態になる。
次いで、挿入コイル６２、規制管６３及び操作ワイヤ６９を一体的に移動させることにより把持部材４０を病変部Ｘに近づけて、把持部材４０の把持爪４７が所望の位置に来たところで操作ワイヤ６９を（上記切断力より小さい力で）挿入コイル６２及び規制管６３に対して相対的に基端側に移動させる。すると、図７及び図１３に示すように把持部材４０が全閉状態となるので、把持部材４０の一対の把持爪４７が病変部Ｘの近傍を把持する（図１３参照）。
この状態で、操作ワイヤ６９を上記切断力以上の強い力で引くと、図１４に示すようにループワイヤ４９が切断する。そのため、内視鏡２０を収納筒部材５０から離れる方向に移動させると、磁気アンカー３０、連結ひも３５、把持部材４０及び収納筒部材５０からなる一体物が内視鏡２０から完全に分離する（図１５参照）。 Next, when the operation wire 69 is pulled toward the base end side (with a force smaller than the cutting force), the loop wire 49 and the gripping member 40 move relative to the storage tube member 50 toward the base end side of the operation wire 69. As shown in FIG. 6, the pair of opening / closing pieces 41 of the gripping member 40 are fully opened.
Next, the insertion coil 62, the restriction tube 63, and the operation wire 69 are integrally moved to bring the gripping member 40 closer to the lesioned part X. When the gripping claw 47 of the gripping member 40 reaches a desired position, the operation wire 69 is moved. Is moved to the proximal side relative to the insertion coil 62 and the restriction tube 63 (with a force smaller than the cutting force). Then, as shown in FIGS. 7 and 13, the gripping member 40 is fully closed, so that the pair of gripping claws 47 of the gripping member 40 grips the vicinity of the lesion X (see FIG. 13).
In this state, when the operation wire 69 is pulled with a force stronger than the cutting force, the loop wire 49 is cut as shown in FIG. Therefore, when the endoscope 20 is moved in a direction away from the storage cylinder member 50, the integrated object including the magnetic anchor 30, the connecting string 35, the gripping member 40, and the storage cylinder member 50 is completely separated from the endoscope 20 ( FIG. 15).

すると、磁気アンカー３０が永久磁石１２側に吸引されることにより、図１５及び図１６に示すように連結ひも３５全体が緊張するので、病変部Ｘと正常組織との境界部に切除部分が形成される。図１６の仮想線に示すように、術者が磁気アンカー誘導装置１０Ａ（オーバーチューブ１１）の基端部側（体外に位置している部分）を操作することにより臓器Ｂ内における永久磁石１２の位置を変えると、病変部Ｘの周辺部分の持ち上げ方向や持ち上げ量が変化するので、最も切除が容易な状態となるまで磁気アンカー誘導装置１０Ａを移動させる。そして、正常組織との境界部の間に十分な大きさの切除部分が形成されたら、内視鏡２０の処置具挿通路２６に挿入した高周波メス７０の先端部７１によって病変部Ｘを臓器Ｂから切除する。
切除が終わったら、内視鏡２０の処置具挿通路２６に（高周波メス７０の代わりに）把持鉗子（図示略）を挿入し、把持鉗子によって磁気アンカー３０、連結ひも３５、収納筒部材５０のいずれかを把持し、把持部材４０を病変部Ｘの近傍部分から引き離す。そして、内視鏡２０を患者Ａの体外に引き出すことにより、磁気アンカー３０、連結ひも３５、把持部材４０及び収納筒部材５０からなる一体物を切除した病変部Ｘと共に患者の体外に回収する。そして最後に、切除した部分の縫合、消毒などの処置を行う。 Then, when the magnetic anchor 30 is attracted to the permanent magnet 12 side, the entire connecting string 35 is tensioned as shown in FIGS. 15 and 16, so that an excised portion is formed at the boundary between the lesion X and the normal tissue. Is done. As shown by the phantom line in FIG. 16, the surgeon operates the proximal end side (portion located outside the body) of the magnetic anchor guiding device 10 </ b> A (overtube 11) to move the permanent magnet 12 in the organ B. When the position is changed, the lifting direction and the lifting amount of the peripheral portion of the lesioned part X are changed, so that the magnetic anchor guiding device 10A is moved until the excision is most easily achieved. When a sufficiently large excision portion is formed between the boundary with the normal tissue, the lesion X is removed from the organ B by the distal end 71 of the high-frequency knife 70 inserted into the treatment instrument insertion passage 26 of the endoscope 20. Remove from.
When the resection is completed, a grasping forceps (not shown) is inserted into the treatment instrument insertion passage 26 of the endoscope 20 (instead of the high-frequency knife 70), and the magnetic anchor 30, the connecting string 35, and the storage cylinder member 50 are inserted by the grasping forceps. One of them is gripped, and the gripping member 40 is pulled away from the vicinity of the lesioned part X. Then, by pulling the endoscope 20 out of the body of the patient A, the integrated body made up of the magnetic anchor 30, the connecting string 35, the gripping member 40, and the storage cylinder member 50 is collected outside the patient's body together with the excised lesioned part X. Finally, treatments such as suturing and disinfection of the excised part are performed.

以上説明した本実施形態によれば、臓器Ｂ内において永久磁石１２を磁気アンカー３０に接近させることが可能なので、永久磁石１２が発生する磁力が小さくても永久磁石１２によって磁気アンカー３０を正確に移動（吸引）制御できる。このように本実施形態では永久磁石１２を小型化できるので、磁気アンカー誘導装置１０Ａは安価に製造できる。
さらに、永久磁石１２と磁気アンカー３０の距離を近づけることができるので、体外に配置した大型の磁力発生装置を用いる場合に比べて磁気アンカー３０を正確かつ容易に移動制御可能である。
しかも、磁気アンカー３０の吸引方向を変えるときに、患者の体位を変えたり、ベッドを移動させる必要がないので、患者や術者の負担は小さい。 According to the present embodiment described above, the permanent magnet 12 can be brought close to the magnetic anchor 30 in the organ B. Therefore, even if the magnetic force generated by the permanent magnet 12 is small, the magnetic anchor 30 is accurately moved by the permanent magnet 12. Movement (suction) can be controlled. Thus, in this embodiment, since the permanent magnet 12 can be reduced in size, 10 A of magnetic anchor guidance apparatuses can be manufactured cheaply.
Furthermore, since the distance between the permanent magnet 12 and the magnetic anchor 30 can be reduced, it is possible to control the movement of the magnetic anchor 30 more accurately and easily than when using a large magnetic force generator arranged outside the body.
In addition, when changing the suction direction of the magnetic anchor 30, it is not necessary to change the patient's body position or move the bed, so the burden on the patient and the operator is small.

以上、本発明について上記実施形態を利用して説明したが、本発明は様々な変更を施しながら実施可能である。
例えば、図１７に示すように長めの連結ひも３５を利用することにより、連結ひも３５を緊張させた状態で磁気アンカー３０を永久磁石１２に吸着させてもよい。このようにすると、臓器Ｂ内において永久磁石１２と磁気アンカー３０が一緒に移動するので、磁気アンカー３０をより正確に移動制御できるようになる。 As mentioned above, although this invention was demonstrated using the said embodiment, this invention can be implemented, giving various changes.
For example, as shown in FIG. 17, the magnetic anchor 30 may be attracted to the permanent magnet 12 in a state where the connection string 35 is tensioned by using a long connection string 35. In this way, since the permanent magnet 12 and the magnetic anchor 30 move together in the organ B, the movement control of the magnetic anchor 30 can be performed more accurately.

さらに、図１８に示すような磁気アンカー誘導装置１０Ｂとして実施することも可能である。この磁気アンカー誘導装置１０Ｂは、内視鏡８０（基本構成は内視鏡２０と同じ）の挿入部２２に５つの磁力発生部８１を固定状態で設けたものである。磁力発生部８１を構成する挿入部２２の外皮の内側には挿入部２２の軸線を中心とするコイル８２が設けてあり、隣り合う磁力発生部８１の間（径が細い部分）は湾曲可能となっている。各コイル８２は内視鏡８０に内臓したリード線（図示略）に接続しており、このリード線は内視鏡８０に内臓した駆動電源装置（図示略）に接続している。さらに、この駆動電源装置は上記のリード線とは別のリード線に接続しており、このリード線の駆動電源装置と反対側の端部は内視鏡８０の外部に位置し、該端部には商用電源に接続可能なプラグ（図示略）が設けてある。商用電源から電力を受けるとコイル８２が電磁石となるので、各磁力発生部８１から発生する磁力により上記実施形態と同じ作用効果が得られる。しかも、内視鏡８０に設けたスイッチ（図示略）を操作することにより、５つのコイル８２をそれぞれ個別に操作（電力の供給と遮断）可能なので、永久磁石１２を用いる場合に比べてより幅の広い操作が可能である。 Furthermore, it is also possible to implement as a magnetic anchor guiding device 10B as shown in FIG. In this magnetic anchor guiding device 10B, five magnetic force generating portions 81 are provided in a fixed state on an insertion portion 22 of an endoscope 80 (basic configuration is the same as that of the endoscope 20). A coil 82 centering on the axis of the insertion portion 22 is provided inside the outer skin of the insertion portion 22 constituting the magnetic force generation portion 81, and the space between adjacent magnetic force generation portions 81 (part having a small diameter) can be bent. It has become. Each coil 82 is connected to a lead wire (not shown) built in the endoscope 80, and this lead wire is connected to a drive power supply device (not shown) built in the endoscope 80. Further, the drive power supply device is connected to a lead wire different from the lead wire, and the end portion of the lead wire opposite to the drive power supply device is located outside the endoscope 80, and the end portion Is provided with a plug (not shown) that can be connected to a commercial power source. When the electric power is received from the commercial power source, the coil 82 becomes an electromagnet. Therefore, the same effect as that of the above embodiment can be obtained by the magnetic force generated from each magnetic force generator 81. In addition, by operating a switch (not shown) provided in the endoscope 80, each of the five coils 82 can be individually operated (power supply and interruption), so that it is wider than the case where the permanent magnet 12 is used. Wide operation is possible.

さらに、図１９及び図２０に示すような磁気アンカー誘導装置１０Ｃとして実施することも可能である。
この磁気アンカー誘導装置１０Ｃのオーバーチューブ９０は、硬質材料（例えば樹脂材料）からなるベース管９１と、同じく硬質材料（例えば樹脂材料）からなりベース管９１の外周面にスライド自在に嵌合したスライド管９２と、を備えている。ベース管９１の表面には指標（目盛り）９３が付してあり、かつ、ベース管９１とスライド管９２の間にはスライド管９２がベース管９１から脱落するのを防止するストッパ機構が設けてある。さらに、スライド管９２の先端面には両端が開口するゴム管９４の一端が固定してあり、ゴム管９４の外周面の先端部には永久磁石１２が固定してある。
図２０に示すように、この磁気アンカー誘導装置１０Ｃの内部に内視鏡２０の挿入部２２を通し、ベース管９１の基端部を挿入部２２の基端部（折れ止めゴム）に固定状態で嵌合すると、挿入部２２の先端部が永久磁石１２の先端開口部から突出する。そして、このように一体化した内視鏡２０の挿入部２２と磁気アンカー誘導装置１０Ｃのゴム管９４を患者の体内に挿入し、患者の体外においてスライド管９２をベース管９１に対してスライドさせれば、永久磁石１２を所望の位置に移動させることが可能である。しかも、ベース管９１に指標９３を付したことにより、術者はスライド管９２のベース管９１に対するスライド量を把握できるので、術者は患者の体内に位置する永久磁石１２を所望の位置に正確に移動させることが可能である。 Furthermore, it is also possible to implement as a magnetic anchor guiding device 10C as shown in FIGS.
The overtube 90 of the magnetic anchor guiding device 10C includes a base tube 91 made of a hard material (for example, a resin material) and a slide that is slidably fitted to the outer peripheral surface of the base tube 91, which is also made of a hard material (for example, a resin material). A tube 92. An index (scale) 93 is attached to the surface of the base tube 91, and a stopper mechanism is provided between the base tube 91 and the slide tube 92 to prevent the slide tube 92 from falling off the base tube 91. is there. Further, one end of a rubber tube 94 that is open at both ends is fixed to the front end surface of the slide tube 92, and the permanent magnet 12 is fixed to the front end portion of the outer peripheral surface of the rubber tube 94.
As shown in FIG. 20, the insertion portion 22 of the endoscope 20 is passed through the magnetic anchor guide device 10 </ b> C, and the base end portion of the base tube 91 is fixed to the base end portion (folding rubber) of the insertion portion 22. , The distal end of the insertion portion 22 protrudes from the distal opening of the permanent magnet 12. Then, the insertion part 22 of the endoscope 20 integrated in this way and the rubber tube 94 of the magnetic anchor guiding device 10C are inserted into the patient's body, and the slide tube 92 is slid with respect to the base tube 91 outside the patient's body. Then, it is possible to move the permanent magnet 12 to a desired position. Moreover, since the operator can grasp the slide amount of the slide tube 92 with respect to the base tube 91 by attaching the index 93 to the base tube 91, the operator can accurately place the permanent magnet 12 located in the patient's body at a desired position. It is possible to move to.

また、オーバーチューブ１１やゴム管９４から永久磁石１２を省略した上で、オーバーチューブ１１やゴム管９４の内部に上述したコイル、リード線、駆動電源装置等を設けたり、内視鏡の挿入部の内部に永久磁石を固定状態で埋設してもよい。
さらに、上記実施形態及び各変形例における永久磁石や電磁石（コイル）の数に制限はなく、一つでも複数でもよい。 Further, the permanent magnet 12 is omitted from the overtube 11 and the rubber tube 94, and the above-described coil, lead wire, drive power supply device, etc. are provided inside the overtube 11 and the rubber tube 94, or the insertion portion of the endoscope. A permanent magnet may be embedded in a fixed state.
Furthermore, the number of permanent magnets and electromagnets (coils) in the embodiment and each modification is not limited, and may be one or more.

本発明の一実施形態の磁気アンカー誘導装置の側面図である。It is a side view of the magnetic anchor guidance apparatus of one Embodiment of this invention. 図１のII−II矢線に沿う断面図である。It is sectional drawing which follows the II-II arrow line of FIG. 内視鏡の全体図である。1 is an overall view of an endoscope. 磁気アンカーと把持装置の縦断面図である。It is a longitudinal cross-sectional view of a magnetic anchor and a holding device. 図４のＶ−Ｖ矢線に沿う把持装置の断面図である。It is sectional drawing of the holding | gripping apparatus which follows the VV arrow line of FIG. 把持部材が全開状態にあるときの図５と同様の断面図である。It is sectional drawing similar to FIG. 5 when a holding member exists in a full open state. 把持部材が全閉状態になったときの図５と同様の断面図である。It is sectional drawing similar to FIG. 5 when a holding member will be in a fully closed state. 患者の臓器内に磁気アンカー誘導装置と内視鏡を挿入した状態を示す図である。It is a figure which shows the state which inserted the magnetic anchor guidance apparatus and the endoscope in the patient's organ. 挿入部の先端から、挿入管、挿入コイル、及びフック部材が突出した状態を示す、内視鏡先端部の拡大縦断側面図である。It is an expansion vertical side view of the endoscope front-end | tip part which shows the state which the insertion tube, the insertion coil, and the hook member protruded from the front-end | tip of an insertion part. 磁気アンカー及び把持装置を操作装置に接続した状態を示す拡大縦断側面図である。It is an expanded vertical side view which shows the state which connected the magnetic anchor and the holding device to the operating device. 磁気アンカー及び把持装置の内視鏡の挿入部への装着が完了したときの挿入部、磁気アンカー、把持装置、操作装置及び内視鏡先端部の拡大縦断側面図である。It is an expansion vertical side view of an insertion part, a magnetic anchor, a grasping device, an operation device, and an endoscope front-end | tip part when mounting to the insertion part of an endoscope of a magnetic anchor and a grasping device is completed. 臓器内において、磁気アンカー及び把持装置を挿入管から外部に押し出し、かつ把持部材を開いた状態を示す図１１と同様の拡大縦断側面図である。FIG. 12 is an enlarged longitudinal sectional side view similar to FIG. 11 showing a state where the magnetic anchor and the grasping device are pushed out from the insertion tube to the outside and the grasping member is opened in the organ. 把持部材が患部を把持したときの図１１と同様の拡大縦断側面図である。FIG. 12 is an enlarged longitudinal side view similar to FIG. 11 when the gripping member grips the affected area. ループワイヤが切断したときの図１１と同様の拡大縦断側面図である。It is an enlarged vertical side view similar to FIG. 11 when the loop wire is cut. 磁気アンカー及び把持装置が内視鏡から完全に切り離されたときの臓器、磁気アンカー、及び把持装置の拡大縦断側面図である。It is an expansion vertical side view of an organ, a magnetic anchor, and a grasping device when a magnetic anchor and a grasping device are completely cut off from an endoscope. 把持部材が臓器の内壁を把持した状態で、永久磁石の磁力によって磁気アンカーを移動させている状態を示す拡大縦断側面図である。It is an expanded vertical side view which shows the state which is moving the magnetic anchor with the magnetic force of a permanent magnet in the state which the holding member hold | gripped the inner wall of the organ. 変形例の図１６と同様の拡大縦断側面図である。It is an expansion vertical side view similar to FIG. 16 of a modification. 別の変形例の一部を破断して示す断面図である。It is sectional drawing which fractures | ruptures and shows a part of another modification. さらに別の変形例の磁気アンカー誘導装置の側面図である。It is a side view of the magnetic anchor guidance apparatus of another modification. 内視鏡に磁気アンカー誘導装置を装着した状態を示す側面図である。It is a side view which shows the state which mounted | wore the endoscope with the magnetic anchor guidance apparatus.

Explanation of symbols

１０Ａ１０Ｂ１０Ｃ磁気アンカー誘導装置
１１オーバーチューブ
１２永久磁石（磁力発生装置）
１３連結部材
２０内視鏡
２１操作部
２２挿入部
２３ユニバーサルチューブ
２４コネクタ部
２５先端面
２６処置具挿通路
２７処置具挿通路の出口開口
２８処置具挿通用突部
２９ゴムキャップ
３０磁気アンカー
３５連結ひも（連結部材）
４０把持部材
４１開閉片
４２基端部
４３中間部
４４先端把持部
４５第１傾斜部（第１接触部）
４６第２傾斜部
４７把持爪
４９ループワイヤ
５０収納筒部材
５１大径部
５２小径部
５３テーパ面
５４スリット
５５内部孔
６０操作装置
６１挿入管
６２挿入コイル
６３規制管
６４大径部
６５小径部
６６環状段部
６８フック部材
６９操作ワイヤ（牽引部材）
７０高周波メス
７１先端部
８０内視鏡
８１磁力発生部
８２コイル（電磁石）（磁力発生装置）
９０オーバーチューブ
９１ベース管
９２スライド管
９３指標
９４ゴム管
Ｂ臓器（対象物）
Ｘ病変部（対象部位） 10A 10B 10C Magnetic anchor guide device 11 Over tube 12 Permanent magnet (magnetic force generator)
13 connection member 20 endoscope 21 operation part 22 insertion part 23 universal tube 24 connector part 25 distal end surface 26 treatment tool insertion passage 27 outlet opening 28 of treatment tool insertion passage treatment tool insertion protrusion 29 rubber cap 30 magnetic anchor 35 connection String (connecting member)
40 Grasping member 41 Opening / closing piece 42 Base end portion 43 Intermediate portion 44 Tip gripping portion 45 First inclined portion (first contact portion)
46 Second inclined portion 47 Grip claw 49 Loop wire 50 Storage cylinder member 51 Large diameter portion 52 Small diameter portion 53 Tapered surface 54 Slit 55 Internal hole 60 Operating device 61 Insertion tube 62 Insertion coil 63 Restriction tube 64 Large diameter portion 65 Small diameter portion 66 Annular step 68 Hook member 69 Operation wire (traction member)
70 High-frequency knife 71 Tip 80 Endoscope 81 Magnetic force generator 82 Coil (electromagnet) (magnetic force generator)
90 Overtube 91 Base tube 92 Slide tube 93 Index 94 Rubber tube B Organ (object)
X lesion (target site)

Claims

A magnetic anchor guiding device that moves a magnetic anchor relative to the inner wall by applying a magnetic force to a magnetic anchor made of a magnetic material connected to a gripping member that grips an inner wall of a body cavity of a subject ,
An insertion tube of an endoscope can be inserted , and an overtube that can be inserted into the body cavity ;
A magnetic force generator for generating a magnetic force for attracting the magnetic anchor, provided on the overtube;
An endoscope magnetic anchor guiding device comprising:

The endoscope magnetic anchor guide device according to claim 1,
An endoscopic magnetic anchor guide device in which the magnetic force generator is fixed to the overtube.

A magnetic anchor guiding device that moves a magnetic anchor relative to the inner wall by applying a magnetic force to a magnetic anchor made of a magnetic material connected to a gripping member that grips an inner wall of a body cavity of a subject ,
An endoscope having an insertion portion that can be inserted into the body cavity ;
A magnetic force generator for generating a magnetic force for attracting the magnetic anchor, provided in the insertion portion ;
An endoscope magnetic anchor guiding device comprising:

The endoscope magnetic anchor guide device according to claim 3,
An endoscope magnetic anchor guiding device in which the magnetic force generator is fixed to the insertion portion.

In the magnetic anchor guidance device for endoscopes according to any one of claims 1 to 4,
An endoscope magnetic anchor guiding device in which the magnetic force generator is a permanent magnet.

In the magnetic anchor guidance device for endoscopes according to any one of claims 1 to 4,
A magnetic anchor guiding device for an endoscope, wherein the magnetic force generator is an electromagnet.

In the magnetic anchor guidance device for endoscopes according to claim 5 or 6,
An endoscope magnetic anchor guiding device having a plurality of the magnetic force generating devices.