JP5881920B2 - Medical device advance / retreat device - Google Patents

Description

  The present invention relates to a medical device advance / retreat apparatus that advances / retreats a medical device in the insertion / extraction direction of a medical device inserted into a treatment instrument insertion port of an endoscope.

  Conventionally, when inserting or removing medical devices such as forceps, catheters, and high-frequency knives with respect to a treatment instrument insertion port (treatment instrument channel) of an endoscope apparatus, an operator's hand is not released from the endoscope apparatus. An operable technique is known (see Patent Document 1). In this technique, the medical device is advanced and retracted in the insertion direction by operating a rotating member attached to the treatment instrument insertion port of the endoscope apparatus and connected to a roller that advances and retracts in the insertion direction while holding the medical device.

JP 2003-265406 A

  However, in Patent Document 1 described above, the medical device is inserted into or removed from the treatment instrument insertion port of the endoscope apparatus by operating the rotating member. However, the amount of operation of the rotating member at the time of insertion and removal is large. If they are equal, the amount of movement of the medical device relative to the treatment instrument insertion port is the same, so it is difficult to make fine adjustments to press the medical device against the living tissue with an appropriate force, and depends on the operator's operation technique. The place to do was great.

  This invention is made in view of the above, Comprising: It aims at providing the medical device advance / retreat apparatus which can perform the fine adjustment for pressing a medical device with a suitable force with respect to a biological tissue. .

  In order to solve the above-described problems and achieve the object, a medical device advance / retreat apparatus according to the present invention is a medical device used by being inserted into an endoscope apparatus from a treatment instrument insertion port of the endoscope apparatus. A medical device advancing / retreating device that advances or retracts relative to the treatment instrument insertion port, and advances the medical device according to a rotation direction with respect to the treatment instrument insertion port by rotating in contact with the medical device Alternatively, a rotating member that moves backward is provided, and when the rotating member is rotated by the same rotation angle, the movement amount of the medical device at the time of forward movement is smaller than the movement amount of the medical device at the time of backward movement.

  The medical device advancing / retreating apparatus according to the present invention is a movement that is provided at a position facing the rotating member across the medical device in the above-described invention, and is movable to different positions when the medical device is moving forward and backward. The medical device further includes a member, wherein a distance between the rotating member and the moving member when the medical device is advanced is larger than a distance between the rotating member and the moving member when the medical device is retracted.

  The medical device advance / retreat apparatus according to the present invention is characterized in that, in the above-mentioned invention, the medical device advancing / retreating device further includes a holding part capable of holding the treatment instrument insertion port.

  According to the medical device advance / retreat apparatus of the present invention, there is an effect that the medical device can be pressed against the living tissue with an optimum force.

FIG. 1 is a schematic diagram showing a schematic configuration of a medical system according to an embodiment of the present invention. FIG. 2 is a cross-sectional view having a cut surface through which the measurement probe passes in the medical device advance / retreat apparatus according to the embodiment of the present invention. FIG. 3 is a cross-sectional view schematically showing the operation of the medical device advancement / retraction apparatus when the measurement probe is inserted into the treatment instrument insertion port of the endoscope apparatus according to the embodiment of the present invention. FIG. 4 is a cross-sectional view schematically showing the operation of the medical device advance / retreat apparatus when the measurement probe is removed from the treatment instrument insertion port of the endoscope apparatus according to the embodiment of the present invention. FIG. 5 is a diagram schematically showing the amount of movement of the measurement probe when the medical device advances and retracts according to the embodiment of the present invention. FIG. 6 is a diagram schematically showing the amount of movement of the measurement probe when the medical device advances and retracts according to the embodiment of the present invention.

  DESCRIPTION OF EMBODIMENTS Hereinafter, embodiments for carrying out the present invention (hereinafter referred to as “embodiments”) will be described with reference to the drawings. In the description of the drawings, the same portions are denoted by the same reference numerals for description. Further, the drawings are schematic, and it is necessary to note that the relationship between the thickness and width of each member, the ratio of each member, and the like are different from actual ones. Moreover, the part from which the relationship and ratio of a mutual dimension differ also in between drawings is contained. Note that the present invention is not limited to the present embodiment.

  FIG. 1 is a schematic diagram showing a schematic configuration of a medical system according to an embodiment of the present invention. A medical system 1 illustrated in FIG. 1 captures an image of a body cavity in a subject, and displays the image as an endoscope system 2 and a medical device that measures the properties of biological tissue in the body cavity of the subject. And a medical device advancement / retraction device 5 that adjusts the advancement / retraction of the measurement probe 3 with respect to the treatment instrument insertion port of the endoscope device 21 in the endoscope system 2. .

  First, the configuration of the endoscope system 2 will be described. The endoscope system 2 has a distal end portion inserted into a subject, an endoscope device 21 that captures an image in a body cavity in the subject, and a body cavity in the subject via the endoscope device 21. An illuminating device 22 that irradiates illumination light, a display device 23 that displays an image of a body cavity imaged by the endoscope device 21, and a control device 24 that comprehensively controls each unit of the endoscope system 2. . In addition, the endoscope apparatus 21 includes a treatment instrument insertion port 201 into which a medical device such as a forceps or an injection needle is inserted.

  Next, the configuration of the biological optical measurement device 4 will be described. The bio-optical measurement device 4 is detachable from the endoscope device 21, and includes a measurement probe 3 inserted into the subject via the treatment instrument insertion port 201 of the endoscope device 21, and the measurement probe 3. And a main body device 41 that performs optical measurement on a measurement object such as a biological tissue that is a scatterer and detects a property (characteristic) of the measurement object.

  The measurement probe 3 is configured using at least a plurality of optical fibers. Specifically, the measurement probe 3 includes a plurality of illumination fibers (illumination channels) that emit illumination light to the measurement object and a plurality of incident light beams that are reflected and / or scattered from the measurement object at different angles. And a light receiving fiber (light receiving channel). The measurement probe 3 emits illumination light supplied from the main body device 41 via the base end portion 31, a flexible end portion 32 that is detachably connected to the main body device 41, and the base end portion 31. And a tip 33 for receiving the return light of the illumination light from the measurement object. The tip 33 is provided with a rod lens 33a that keeps the distance between the measurement object and the tip 33 constant.

  The main body device 41 is a light emitting element that is an incoherent light source such as a white LED (Light Emitting Diode) that emits illumination light to the measurement probe 3, and the illumination light emitted from the distal end portion 33 of the measurement probe 3 is a measurement object. An imaging element such as a CCD (Charge Coupled Device) or a CMOS (Complementary Metal Oxide Semiconductor) that generates an electrical signal by receiving photoelectrically converted return light from reflected and / or scattered illumination light, and a bio-optical measurement device 4 is configured using a CPU (Central Processing Unit) or the like that comprehensively controls each unit.

  Next, the configuration of the medical device advance / retreat apparatus 5 will be described. FIG. 2 is a cross-sectional view having a cut surface through which the measurement probe 3 passes in the medical device advance / retreat apparatus 5.

  As shown in FIG. 2, the medical device advancing / retreating device 5 endoscopically views the measurement probe 3 via the distal end portion 51 that is detachably attached to the treatment instrument insertion port 201 of the endoscope apparatus 21. And a main body 52 that moves forward and backward in both directions of insertion and extraction into the treatment instrument insertion port 201 of the mirror device 21.

  The distal end portion 51 has a substantially cylindrical shape, and is configured using an adhesive on the distal end side of the main body portion 52. The inner diameter of the tip portion 51 is formed larger than the outer diameter K of the flange portion 201a. The tip 51 and the main body 52 may be formed integrally.

  The main body 52 moves the measurement probe 3 forward in the insertion direction of the treatment instrument insertion port 201 or a rotation member 521 that moves backward from the insertion direction of the treatment instrument insertion port 201 and a position facing the rotation member 521 with the measurement probe 3 interposed therebetween. A moving member 522 that is provided and is movable in the insertion direction in which the measurement probe 3 moves forward or in the opposite direction in which the measurement probe 3 moves backward, and a holding portion 523 that holds the moving member 522 movably.

  The rotating member 521 has a disk shape and is provided rotatably on the holding portion 523. The rotating member 521 rotates in contact with the measurement probe 3 to advance or retract the measurement probe 3 with respect to the treatment instrument insertion port 201 according to the rotation direction. Specifically, the rotation member 521 moves the measurement probe 3 forward in the insertion direction of the treatment instrument insertion port 201 or moves backward from the insertion direction of the treatment instrument insertion port 201 by sandwiching the measurement probe 3 with the moving member 522. Let Further, when the rotation member 521 rotates by the same rotation angle, the movement amount of the measurement probe 3 at the time of forward movement is smaller than the movement amount of the measurement probe 3 at the time of backward movement.

  The moving member 522 has a substantially triangular prism shape and is configured using a resin member or the like. The bottom surface of the moving member 522 is in contact with the measurement probe 3. The moving member 522 moves to a different position when the measurement probe 3 moves forward and backward.

  The holding portion 523 includes an accommodating portion 524 that movably accommodates the moving member 522 in a direction opposite to the insertion direction of the measurement probe 3 with respect to the treatment instrument insertion port 201 or the insertion direction of the measurement probe 3 with respect to the treatment instrument insertion port 201. And a sandwiching portion 525 that grips the treatment instrument insertion port 201 of the endoscope apparatus 21.

  The accommodating portion 524 is formed such that the length in the longitudinal direction in the insertion direction of the measurement probe 3 is larger than the length in the longitudinal direction of the moving member 522. The accommodating portion 524 has one end 524 a in contact with one end of the moving member 522 to restrict movement of the moving member 522, while the other end 524 b is in contact with the other end of the moving member 522 to restrict movement of the moving member 522. To do.

  The clamping part 525 is configured using a leaf spring. The clamping unit 525 clamps (holds) the flange portion 201 a of the treatment instrument insertion port 201 of the endoscope apparatus 21.

  In the medical system 1 having the above configuration, an operation when the measurement probe 3 of the bio-optical measurement device 4 is inserted into or extracted from the subject from the treatment instrument insertion port 201 of the endoscope device 21 using the medical device advance / retreat apparatus 5. Will be described. FIG. 3 is a cross-sectional view schematically showing the operation of the medical device advance / retreat apparatus 5 when the measurement probe 3 is inserted into the treatment instrument insertion port 201 of the endoscope apparatus 21. FIG. 4 is a cross-sectional view schematically showing the operation of the medical device advance / retreat apparatus 5 when the measurement probe 3 is removed from the treatment instrument insertion port 201 of the endoscope apparatus 21.

  First, an operation when the measurement probe 3 is inserted into the treatment instrument insertion port 201 of the endoscope apparatus 21 will be described.

  As shown in FIG. 3, in a state where the measurement probe 3 is inserted between the rotating member 521 and the moving member 522 of the medical device advance / retreat apparatus 5, the operator turns the rotating member 521 counterclockwise (arrow) with a constant force. By rotating to A), the measurement probe 3 is inserted into the treatment instrument insertion port 201. In this case, the moving member 522 moves in the insertion direction of the treatment instrument insertion port 201 as the measurement probe 3 moves forward, and comes into contact with the one end 524a of the housing portion 524 and stops moving. As a result, the distance (gap) between the moving member 522 and the rotating member 521 is increased, whereby the frictional force of the rotating member 521 with respect to the measurement probe 3 is weakened, and the amount of movement of the measuring probe 3 when the rotating member 521 moves forward is reduced. This is smaller than the amount of movement of the measurement probe 3 during the backward movement (FIG. 3A → FIG. 3B). Specifically, as shown in FIG. 5, when the rotating member 521 is rotated counterclockwise at the rotation angle θ <b> 1, the amount of movement of the measurement probe 3 during forward movement is between the rotating member 521 and the probe 3. As the frictional force becomes weaker, slipping occurs, resulting in a movement amount D1 shorter than the arc length formed by the rotation angle θ1. If the movement amount D1 is not appropriately manipulated, the probe 3 causes unintended contact with the tissue and excessive pressing, and it is difficult to press the probe 3 against the tissue with an appropriate force. In addition, since the human fingertip cannot move very finely, it is impossible to give the rotation member 521 a very delicate rotation angle θ1. However, according to the structure of the present invention, the movement amount D1 of the probe 3 is inevitably smaller than the arc length formed by the rotation angle θ1 given to the rotating member 521 by a human finger, and the rotating member 521 is somewhat rough. The movement of the probe 3 becomes delicate depending on the handling. Therefore, the measurement probe 3 as a medical device can be pressed against the living tissue with an appropriate force.

  Next, an operation when the measurement probe 3 is removed from the treatment instrument insertion port 201 of the endoscope apparatus 21 will be described.

  As shown in FIG. 4, in a state where the measurement probe 3 is inserted between the rotating member 521 and the moving member 522 of the medical device advance / retreat apparatus 5, the operator rotates the rotating member 521 clockwise with a constant force (arrow B). ) To remove the measurement probe 3 from the treatment instrument insertion port 201. In this case, the moving member 522 moves in the direction opposite to the insertion direction of the treatment instrument insertion port 201 as the measurement probe 3 is retracted, and comes into contact with the other end 524b of the storage portion 524 to stop moving. As a result, the distance (gap) between the moving member 522 and the rotating member 521 is reduced, so that the frictional force of the rotating member 521 with respect to the measurement probe 3 is increased, and the amount of movement by which the measuring probe 3 is moved backward by the rotating member 521 is measured. It becomes larger than the moving amount for moving the probe 3 forward (FIG. 4 (a) → FIG. 4 (b)). Specifically, as shown in FIG. 6, when the rotating member 521 is rotated clockwise at the rotation angle θ <b> 2, no slip occurs between the rotating member 521 and the probe 3 as in the forward movement, and the backward movement is performed. The amount of movement of the measurement probe 3 at is the same amount of movement D2 (D1 <D2) as the arc length formed by the rotation angle θ2. As a result, the measurement probe 3 can be easily removed from the treatment instrument insertion port 201 of the endoscope apparatus 21.

  According to the embodiment of the present invention described above, the measurement probe 3 as a medical device can be pressed against a living tissue with an appropriate force.

  In the embodiment of the present invention, the measurement probe 3 that measures the properties of a living tissue is described as a medical device. However, an injection needle, forceps, an electric knife, a catheter, and the like can be applied as a medical device. .

  As described above, the present invention can include various embodiments not described herein, and various design changes can be made within the scope of the technical idea specified by the claims. It is.

DESCRIPTION OF SYMBOLS 1 Medical system 2 Endoscope system 3 Measurement probe 4 Bio-optical measurement apparatus 5 Medical device advance / retreat apparatus 21 Endoscope apparatus 22 Illumination apparatus 23 Display apparatus 24 Control apparatus 31 Base end part 32 Flexible part 33 Front end part 41 Main body apparatus 51 Tip portion 52 Body portion 201 Treatment instrument insertion port 201a Flange portion 521 Rotating member 522 Moving member 523 Holding portion 524 Storage portion 524a One end portion 524b The other end portion 525

Claims (3)

A medical device advancing / retreating device that advances or retracts a medical device used by being inserted into the endoscope apparatus from the treatment instrument insertion port of the endoscope apparatus, with respect to the treatment instrument insertion port,
A rotating member that advances or retracts the medical device according to a rotation direction with respect to the treatment instrument insertion port by rotating in contact with the medical device;
The medical device advancing / retreating device characterized in that a frictional force of the rotating member with respect to the medical device at the time of forward movement is smaller than a frictional force of the rotating member with respect to the medical device at the time of backward movement. The medical device advancement / retraction apparatus according to claim 1, wherein when the rotation member rotates by the same rotation angle, the movement amount of the medical device at the time of forward movement is smaller than the movement amount of the medical device at the time of backward movement. A moving member provided at a position facing the rotating member across the medical device, and further movable to different positions when the medical device is advanced and retracted;
The medical device according to claim 2 , wherein a distance between the rotating member and the moving member when the medical device moves forward is larger than a distance between the rotating member and the moving member when the medical device moves backward. Device advance / retreat device.

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