JP6192407B2 - Osmotic chemical administration system - Google Patents

Description

The present invention is, for example, relates to osmotic drug solution administration system used to administer the permeability chemical such as transparency solution to the affected area which exists within the lumen wall of the living body.

  Endoscopic submucosal dissection (ESD) and other catheter treatments such as endoscopic submucosal dissection (endoscopic submucosal dissection) are blood vessels that run in living tissue such as organs, such as intraoperative or postoperative bleeding. It has been a conventional problem to avoid accidents that damage nerves and the like.

However, there is an attempt to visualize a site that is not desired to be damaged by penetrating a penetrating agent such as a staining agent or a contrast agent into a living tissue.
Conventionally, when such an osmotic agent is administered to an affected area using an endoscope, for example, a spraying device as described in the following Patent Documents 1 to 4 is used to spray a certain amount of a chemical solution at a time. It is done by

  The apparatus described in Patent Document 1 has an air supply means and a liquid supply means that can simultaneously supply and supply air, and ejects liquid in a mist form from the channel opening at the distal end of the insertion portion of the endoscope. Yes.

  In addition, the device described in Patent Document 2 is a nozzle provided at the distal end of an insertion portion of an endoscope by automatically switching one of the air supply pressure and the liquid supply pressure in conjunction with the pressure switching. The gas and the liquid are mixed and sprayed.

  Further, in the apparatus described in Patent Document 3, the liquid that has passed through the rotation guide groove disposed at the tip of the liquid feeding pipe rotates in the liquid rotating chamber, and forwards from an ejection hole formed in the center of the tip surface of the liquid rotating chamber. In the endoscope sprayer that is ejected in the direction of the surface, the inner wall surface on the tip side of the liquid rotation chamber is convex toward the ejection hole side and the side closer to the center than the periphery approaches the axis perpendicularly. By forming in a changed shape, a sufficiently wide spray range is obtained.

  In addition, the device described in Patent Document 4 is an endoscope spray in which liquid that has passed through a rotation guide groove disposed at the tip of a liquid feeding tube rotates in a liquid rotating chamber and is released while diffusing from the liquid rotating chamber. In the device, the front of the liquid rotating chamber is closed, and an annular liquid ejection port is formed on the outer peripheral wall portion so as to uniformly spray the liquid on the lumen wall.

JP 2003-310540 A JP 09-294715 A JP 2001-137349 A JP 2001-104490 A

By the way, the living body is in various wet states for each part, and the target part where it is desired to apply the osmotic drug does not always exist in the direction of gravity in the living body lumen.
For this reason, in the technique of spraying a permeable drug onto a target site existing at a position opposite to the gravitational direction by the devices described in Patent Documents 1 to 4, the liquid droplets of the medicinal liquid sprayed on the surface of the lumen inner wall are in the gravitational direction. In some cases, it may flow, and it becomes difficult to stably place the osmotic agent in a target site that exists in a direction opposite to the direction of gravity.

In general, the medicinal solution of the osmotic drug is not useful for living tissue.
For this reason, when the affected part is located only in the direction opposite to the gravitational direction and the biological tissue in the gravitational direction is healthy, when the drug solution sprayed on the affected part using the devices described in Patent Documents 1 to 4 flows in the gravitational direction, There is a possibility that it may affect the biological tissue that is not desired to be applied.

  Moreover, since the conventional spraying devices as described in Patent Documents 1 to 4 are configured to spray a predetermined amount of a chemical solution onto the target site at a time, a necessary amount of osmotic agent is applied in the direction of gravity. There may be a case where normal biological tissue is affected by flowing in the direction of gravity without penetrating into the internal tissue of the target site until the internal tissue of the target site located in the opposite direction is completely penetrated. Therefore, an administration technique that takes into consideration the influence on normal living tissue while sufficiently obtaining the effect of the osmotic agent is desired.

  As a conventional technique for stably placing a drug solution on an affected part existing in the direction of gravity, for example, a sustained drug release property obtained by coating a stent with a polymer containing a drug as described in WO2009 / 031295 Although there is a stent, it took time to collect the stent after administration to the affected area, and the stent interfered with observation of the affected area during administration of the drug solution, and it was difficult to confirm the effect of the drug solution administration. This will interfere with the diagnosis and treatment of the affected area.

  In addition, for example, there is a balloon that is inflated as described in Japanese Patent Application Laid-Open No. 2008-188212, and a drug holding part is brought into contact with a desired site to apply a chemical solution. In the configuration in which the drug solution is administered in such a state, it is difficult to confirm the effect of the drug solution administration because the balloon hinders observation of the affected area when the drug solution is administered.

The present invention has been made in view of such conventional problems, and can reduce the burden on the living body and the work load, can reduce the loss of the drug solution as much as possible, and can be administered at a position against gravity. It is possible to adjust the optimal amount in a state where the drug solution is stably placed at the site, and it is possible to administer the drug solution while checking the effect of the drug solution without disturbing the visual field of the administration site and its object is to provide a Do osmotic drug solution administration system.

  In order to achieve the above-mentioned object, the present inventors have recently used a clearing solution that has been developed to enhance the biological permeability of light by suppressing light scattering for the medical use as described above. Assumed. That is, the administration which can improve the visibility (see-through property) of the object by making the living tissue existing around the object which does not want to be damaged as transparent as possible was examined. An example of the composition of the clearing solution is a water-soluble solution in which glycerol and a surfactant are added to urea, and it penetrates into the living tissue when administered to the living tissue, and the permeated site is physically converted into a jelly form. The pigment component contained in tissues such as skin is made transparent while causing a chemical change. There are other cases where a composition such as polyethylene glycol or glucose is used as the clearing solution. These clearing solutions generally have a variety of physical properties for each composition because of their colorless and transparent properties and the properties that cause physicochemical changes to living tissues, and it is particularly difficult to confirm the degree of penetration. A solution. In addition, the site | part clarified using the clarification liquid can be returned to the original opaque state again by administering physiological saline etc.

In order to reduce the risk of intraoperative or postoperative bleeding using such a clearing solution, it is desired to administer the clearing solution to the affected area before or after the operation to improve the blood vessel see-through ability.
By the way, this clearing solution exhibits its effect only when it penetrates to a sufficient depth into the administered biological tissue. Therefore, there is a certain time lag between the administration of the clearing solution and the obtaining of the clearing effect. Therefore, the present invention is, when using a transparent liquid to a surgical or the like, in advance, also provides also possible systems that allowed to penetrate the transparent liquid inside the tissue of the affected area. In the present invention, unless otherwise specified in the embodiment or the like, the osmotic drug refers to a broadly defined drug including a clearing solution.

  An osmotic drug solution administration system according to the present invention is an osmotic drug solution administration system that administers an osmotic drug solution to an inner wall of a living body lumen using an endoscope, and the osmotic drug solution from the side of the distal end portion of the endoscope. To a surface of the inner wall of the living body lumen, and a medicinal solution spraying section configured to be sprayable onto the surface of the inner wall of the living body lumen, and the osmotic drug solution sprayed onto the surface of the inner wall of the living body lumen to the inner tissue of the inner wall of the living body lumen A first step in which a penetrating degree detecting unit for detecting a penetrating degree is detected, and the medicinal solution spraying section sprays the penetrating medicinal solution on the surface of the inner wall of the living body lumen; and the penetrating degree after the first step. Until the degree of penetration of the osmotic drug solution detected by the detection unit into the internal tissue of the inner wall of the biological lumen reaches a predetermined level, the inner wall of the biological lumen of the osmotic drug solution by the drug solution spraying unit Wait for spraying on the surface of Alternately repeating the second step, it is characterized in that so as to administer the permeable chemical liquid of a predetermined amount relative to the body lumen wall divided by intermittently several times.

  In the osmotic solution administration system of the present invention, when the penetration of the osmotic solution detected by the penetration level detection unit into the internal tissue of the inner wall of the living body lumen reaches a predetermined level. In addition, it is preferable to have a spray operation control unit that controls the operation of the chemical solution spray unit so that the chemical solution spray unit sprays the osmotic chemical solution onto the surface of the inner wall of the living body lumen.

  In the osmotic solution administration system of the present invention, when the penetration of the osmotic solution detected by the penetration level detection unit into the internal tissue of the inner wall of the living body lumen reaches a predetermined level. In addition, it is preferable to have a spray instructing unit that instructs spraying of the osmotic chemical solution onto the surface of the inner wall of the living body lumen by the chemical solution spraying unit.

  In the osmotic chemical solution administration system of the present invention, it is preferable that the penetration degree detection unit is an interferometer using an optical fiber.

  Further, in the osmotic drug solution administration system of the present invention, the penetration degree detection unit is configured to capture an image of the surface of the inner wall of the living body lumen obtained through the observation optical system of the endoscope; From the image of the surface of the inner wall of the living body lumen imaged by the imaging unit, an image processing unit that extracts a contour shape of the droplet of the osmotic drug solution that is reflected in the image; and the image processing unit that is extracted by the image processing unit A sharpness detecting unit that detects the sharpness of the contour shape of the droplet of the osmotic chemical solution, and the sharpness detected by the sharpness detection unit is the inner wall of the living body lumen of the osmotic chemical solution The degree of penetration into the internal tissue is preferred.

  In the osmotic drug solution administration system of the present invention, a change in the state of the internal tissue of the inner wall of the living body lumen is further detected from an image of the inner wall of the living body lumen obtained through the observation optical system of the endoscope. A state change detection unit configured to detect the state of the internal tissue of the inner wall of the living body lumen detected by the state change detection unit when the state change of the internal tissue reaches a predetermined state. It is preferable to control the operation of the chemical solution spraying unit so as to finish spraying the osmotic chemical solution onto the surface of the inner wall of the living body lumen.

According to the present invention, it is possible to reduce the burden on the living body and the work load, reduce the loss of the drug solution as much as possible, and stably place the drug solution on the administration target site that exists at a position against gravity. in, it is possible to adjust the optimum amount, moreover without disturbing the view of the injection site, osmotic drug solution administered system that can be administered is obtained while confirming the effect of the administration of the drug solution.

BRIEF DESCRIPTION OF THE DRAWINGS It is explanatory drawing which shows schematic structure of the osmotic chemical | medical solution administration system concerning 1st Embodiment of this invention, (a) is a schematic diagram, (b) is a block diagram which shows the principal part structure. It is explanatory drawing which shows typically the example of 1 structure of the osmosis | permeation degree detection part in the osmotic chemical | medical solution administration system of FIG. It is explanatory drawing which shows typically the other structural example of the penetration degree detection part in the osmotic chemical | medical solution administration system of FIG. It is a flowchart which shows the procedure until it completes administering the osmotic chemical | medical solution to the living body lumen inner wall in the osmotic chemical | medical agent administration system of FIG. It is explanatory drawing which shows the timing chart of administration until it completes administering an osmotic chemical | medical solution to a biological lumen inner wall in the osmotic chemical | medical solution administration system of FIG.

Prior to the description of the embodiment, the function and effect of the present invention will be described.
The osmotic drug solution administration system of the present invention is sprayed from the side of the endoscope tip part to the surface of the inner wall of the living body lumen from the side of the endoscope tip part, and sprayed from the drug solution spraying part to the surface of the inner wall of the body lumen. And a first step of spraying the osmotic chemical liquid onto the surface of the inner wall of the living body lumen, the penetrating degree detecting unit detecting the degree of penetration of the osmotic drug solution into the inner tissue of the inner wall of the living body lumen. Until the degree of penetration of the osmotic drug solution detected by the penetration level detection unit after the first step into the internal tissue of the inner wall of the living body lumen reaches a predetermined level, The second step of waiting for spraying on the surface of the inner wall of the living body lumen is alternately repeated, and a predetermined amount of osmotic drug solution is intermittently administered to the inner wall of the living body lumen in a plurality of times.

  According to the osmotic drug administration system of the present invention, the osmotic drug solution of the total dose necessary for obtaining a sufficient effect on the inner wall of the living body lumen is divided into a plurality of times to form mist-like droplets. Since it can supply, the droplet of a permeable chemical | medical solution becomes easy to remain on the surface of a biological lumen inner wall. And even if the osmotic drug solution administration target site on the inner wall of the living body lumen is located at a position opposite to the gravity direction, the sprayed droplets of the osmotic drug solution can be stably administered without flowing in the gravity direction. it can.

  Further, according to the osmotic drug solution administration system of the present invention, spraying is applied to the administration target site located at a position opposite to the gravity direction on the inner wall of the living body lumen by allowing the osmotic drug solution to wait for a predetermined time after spraying. It is possible to prevent the osmotic chemical liquid droplets from becoming large and flowing in the direction of gravity, and to allow the osmotic chemical liquid to permeate the internal tissue of the inner wall of the living body lumen.

  According to the osmotic drug solution administration system of the present invention, the droplets of the osmotic drug sprayed on the administration target site located at the position opposite to the gravity direction on the inner wall of the living body lumen do not flow in the gravity direction. The optimal amount of osmotic chemical solution that is necessary to obtain a sufficient effect on the inner wall of a living body lumen can be supplied to suppress the loss of the osmotic chemical solution, and the administration of the osmotic chemical solution is healthy However, it is possible to eliminate the administration of the osmotic chemical solution to an unnecessary site, and it is not necessary to give a burden to healthy living tissue.

  In addition, as in the osmotic drug solution administration system of the present invention, if the osmotic drug solution is administered from the side of the endoscope tip part through the drug solution spraying part that sprays the osmotic drug solution on the surface of the inner wall of the body lumen, For example, the field of view of the administration site of the drug solution is not obstructed as in the configuration using a balloon for sustained release of the drug solution and the drug sustained release stent described in WO2009 / 031295. For this reason, it is possible to administer the osmotic drug solution while confirming the effect at the administration site on the inner wall of the body lumen.

  Therefore, according to the osmotic chemical solution administration system of the present invention, the burden on the living body and the work load can be reduced, the loss of the chemical solution can be reduced as much as possible, and the chemical solution can be applied to the administration target site that exists at a position against gravity. Penetrating drug solution administration system that can adjust the optimal amount in a state where it is stably placed, and can be administered while confirming the effect of the drug solution without disturbing the visual field of the administration site Is obtained.

By the way, since the surface of the inner wall of the living body lumen is covered with the body fluid, it is easy to mix with the body fluid even if the drug solution is sprayed. For this reason, it is not easy for the operator to confirm the degree of penetration of the osmotic chemical solution sprayed on the inner wall of the living body lumen into the internal tissue of the inner wall of the living body lumen through the observation optical system of the endoscope. Work burden increases.
However, in the osmotic drug solution administration system of the present invention, when the degree of penetration of the osmotic drug solution detected by the penetration level detection unit into the internal tissue of the inner wall of the body lumen reaches a predetermined level, the drug solution spraying unit If there is a spray operation control unit that controls the operation of the chemical solution spraying part to spray the osmotic chemical solution on the surface of the inner wall of the living body lumen, the optimal timing for spraying the osmotic chemical solution through the chemical solution spraying part Can be easily obtained and the osmotic chemical solution can be automatically sprayed at the optimal timing, eliminating the need for the operator to confirm the spray instruction and manually operating the chemical spray unit. Work burden can be reduced.

  Further, in the osmotic drug administration system of the present invention, when the degree of penetration of the osmotic drug solution detected by the penetration degree detection unit into the internal tissue of the inner wall of the body lumen reaches a predetermined level, the drug spray If there is a spray instruction unit for instructing spraying of the osmotic chemical solution on the surface of the inner wall of the body lumen by the unit, it is possible to reduce the burden on the operator by eliminating the trouble of confirming the spray instruction by the operator. .

  Further, in the osmotic drug solution administration system of the present invention, when the penetration degree detection unit is configured by an interferometer using an optical fiber, the sprayed droplets of the osmotic drug solution are mixed with the body fluid on the surface of the inner wall of the living body lumen. Even if it is difficult to determine the degree of penetration of the osmotic chemical from the observation image into the internal tissue of the inner wall of the living body lumen, the surface of the inner wall of the living body lumen and the inner wall of the living body lumen The change in the optical path length of the signal light based on the difference in refractive index from the body fluid adhering to the surface can be distinguished as the difference in intensity of the combined light of the signal light and the reference light. The degree of penetration of the drug solution into the internal tissue of the inner wall of the living body lumen can be accurately detected.

  Further, in the osmotic drug administration system of the present invention, the penetration degree detection unit is configured to capture an image of the surface of the inner wall of the living body lumen obtained through the observation optical system of the endoscope, and the imaging unit captures the image. The image processing unit for extracting the contour shape of the sprayed penetrating chemical liquid droplet in the surface image of the inner wall of the living body lumen, and the sharpness of the contour shape of the penetrating chemical liquid droplet extracted by the image processing unit. If it is configured to have a sharpness detection unit for detection, it is not necessary to newly provide a member for detecting the penetration level at the distal end portion of the endoscope. Therefore, the distal end portion of the endoscope can be suppressed as small as possible, and the degree of penetration of the osmotic drug solution can be detected even with respect to the inner wall of the living body lumen having a small diameter.

  Further, in the osmotic drug administration system of the present invention, the state change detection further detects the state change of the internal tissue of the inner wall of the living body lumen from the image of the inner wall of the living body lumen obtained through the observation optical system of the endoscope And the spray operation control unit is configured so that when the state change of the internal tissue of the inner wall of the living body lumen detected by the state change detecting unit reaches a predetermined state, the inner wall of the living body lumen of the permeable medicinal solution by the medicinal solution spraying unit If it is configured to control the operation of the chemical spraying unit so that the spraying on the surface of the liquid is terminated, it reduces the work burden on the operator and prevents overdosing and supplies the optimal amount of osmotic chemical solution to the biological tube. It can be administered to the lumen wall.

Hereinafter, embodiments of the present invention will be described with reference to the drawings.
First Embodiment FIG. 1 is an explanatory view showing a schematic configuration of an osmotic chemical solution administration system according to a first embodiment of the present invention, wherein (a) is a schematic diagram, and (b) is a block diagram showing a main part configuration. . FIG. 2 is an explanatory view schematically showing a configuration example of a penetration degree detecting unit in the osmotic chemical solution administration system of FIG. FIG. 3 is an explanatory diagram schematically showing another configuration example of the penetration degree detection unit in the osmotic chemical solution administration system of FIG. FIG. 4 is a flowchart showing a procedure until administration of the osmotic drug solution to the inner wall of the living body lumen is completed in the osmotic drug solution administration system of FIG. FIG. 5 is an explanatory diagram showing a timing chart of administration until the osmotic drug solution in the osmotic drug solution administration system of FIG.

  As shown in FIG. 1, the osmotic chemical solution administration system of the present embodiment includes a chemical solution spray unit 1 and a penetration level detection unit 2. In the figure, 3 is a spray operation control unit, 4 is an observation optical system, 5 is a state change detection unit, 10 is a distal end portion of an endoscope, 20 is an osmotic chemical solution, 30 is a biological lumen inner wall, and 30a is a biological tube. This is a diseased part existing in a part of the inner cavity wall. Here, it is assumed that the affected part 30a is located in a direction against gravity.

  The medicinal solution spraying section 1 is composed of a clearing solution spraying device inserted from a forceps channel of an endoscope. The medicinal solution spray unit 1 communicates with the medicinal solution supply path 1 a provided inside the rod-shaped flexible member 11 extending from the endoscope distal end 10 and the supply path 1 a, and the flexible member 11. A plurality of supply ports 1b provided in a ring shape on the side of the endoscope, and a chemical solution supply means such as a pump (not shown) provided in the endoscope main body (not shown) and communicating with the supply path 1a are provided. Thus, the osmotic chemical solution 20 can be sprayed onto the surface of the inner wall 30 of the living body lumen from the side of the endoscope distal end portion 10.

The penetration degree detection unit 2 detects the degree of penetration of the permeable chemical solution 20 sprayed from the chemical solution spray unit 1 onto the surface of the inner wall 30 of the living body lumen into the internal tissue of the inner wall 30 of the living body lumen.
Specifically, the penetration degree detection unit 2 includes, for example, an interferometer 2a using an optical fiber as shown in FIG.
The interferometer 2a using an optical fiber includes a light source unit 2a1, a fiber coupler 2a2, a reference light reflection system 2a3, a probe unit 2a4, and a light detection unit 2a5.
The light source unit 2a1 is configured to emit low coherence light.
The fiber coupler 2a2 includes a light source unit 2a1 through a single mode fiber 2a6, a reference light reflection system 2a3 through a single mode fiber 2a7, a probe unit 2a4 through a single mode fiber 2a8, and a single mode fiber 2a9. Each is connected to the light detection unit 2a5. The fiber coupler 2a2 branches the light from the light source unit 2a1 into the signal light L1 and the reference light L2, and the signal light L1 reflected by the living body lumen inner wall 30 and the reference light L2 from the reference light reflection system 2a3. Are combined and guided to the light detector 2a5.
Reference light reflection system 2a3 is moved lens 2a3 ₁ to the tip of the single mode fiber 2A7, a mirror 2a3 _2, it has a mirror driving unit 2a3 _3, the mirror 2a3 ₂ in the optical axis direction via the mirror drive unit 2a3 ₃ By doing so, the optical path length of the reference light L2 can be changed.
Probe unit 2a4 includes a lens 2a4 ₁ to the tip of the single mode fiber 2A8, the signal light L1 collimated through a lens 2a4 ₁ irradiates the body lumen wall 30, the light reflected by the body lumen wall 30 To the single mode fiber 2a8.
The light detection unit 2a5 detects the intensity of light obtained by combining the signal light L1 and the reference light L2.

The degree of penetration of the osmotic chemical solution 20 using the penetration degree detection unit 2 configured with an interferometer 2a using an optical fiber as shown in FIG. 2 is performed as follows.
Only when the optical path lengths of the signal light L1 and the reference light L2 are substantially equal, the signal light L1 and the reference light L2 interfere with each other, and the interference intensity of the light obtained by combining the signal light L1 and the reference light L2 increases. Since all the Fresnel reflection light generated at the interface having different refractive indexes exists as the signal light L1, the mirror 2a3 ₂ is vibrated at a high speed with an amplitude in the direction of the optical axis via the mirror driving unit 2a3 _3, thereby detecting the light. When the intensity of the light obtained by combining the signal light L1 and the reference light L2 is detected by the unit 2a5, a plurality of interference waveforms corresponding to the positions of the interfaces having different refractive indexes are obtained. This is equivalent to a refractive index cross-sectional profile.
Immediately after spraying the osmotic chemical solution 20 onto the surface of the inner wall 30 of the living body lumen, Fresnel reflected light on the surface of the osmotic solution 20 and Fresnel reflected light at the interface between the osmotic solution 20 and the inner wall 30 of the living body lumen. Is present as the signal light L1, when the penetration degree detection unit 2 is used, two interference waveforms are obtained with an optical path length of the osmotic chemical solution 20 being separated.
When a certain period of time has elapsed, a part of the osmotic drug solution 20 penetrates from the surface of the living body lumen inner wall 30 and a part of the osmotic drug solution 20 remains on the surface of the living body lumen inner wall 30 The Fresnel reflected light on the surface of the osmotic chemical solution 20, the Fresnel reflected light on the interface between the osmotic chemical solution 20 and the surface of the inner wall 30 of the living body lumen, and the permeation through the layer of the inner wall 30 of the living body lumen into which the osmotic drug solution 20 has penetrated. Since the Fresnel reflected light at the interface with the layer of the inner wall 30 of the body lumen into which the sexual chemical solution 20 has not penetrated exists as the signal light L1, when the penetration degree detection unit 2 is used, the optical path length and penetration of the permeable chemical solution 20 Three interference waveforms are obtained by separating the optical path length of the layer of the inner wall 30 of the living body lumen into which the sexual drug solution 20 has permeated.
Further, when all of the osmotic chemical solution 20 has permeated from the surface of the inner wall 30 of the living body lumen, the layer of the inner wall 30 of the living body lumen 30 in which the Fresnel reflected light on the surface of the inner wall 30 of the living body lumen and the osmotic drug solution 20 have permeated. Since the Fresnel reflected light at the interface between the permeable drug solution 20 and the layer of the inner wall 30 of the living body lumen that has not penetrated exists as the signal light L1, when the penetration degree detection unit 2 is used, the osmotic drug solution 20 penetrates the living body. Two interference waveforms are obtained by separating the optical path length of the layer of the lumen inner wall 30.
By monitoring the above process using the permeation degree detection unit 2, it is possible to detect that the degree of permeation into the internal tissue of the inner wall 30 of the living body lumen has reached a predetermined degree.

The penetration degree detection unit 2 is not limited to the configuration including the interferometer 2a using an optical fiber as shown in FIG. For example, in the case where the osmotic drug solution 20 to be administered has a property that it does not mix with the body fluid adhering to the surface of the inner wall 30 of the living body lumen, it penetrates through image processing as shown in FIG. The degree may be detected.
The penetration degree detection unit 2 in FIG. 3 includes an imaging unit 2b1, an image processing unit 2b2, and a sharpness detection unit 2b3.
The imaging unit 2b1 includes an imaging optical system and an imaging element, and captures an image of the surface of the inner wall 30 of the living body lumen formed at a predetermined imaging position via the observation optical system 4 of the endoscope.
The image processing unit 2b2 is provided in an endoscope main body (not shown), and from the image of the surface of the inner wall 30 of the living body lumen imaged by the imaging unit 2b1, the contour of the droplet of the osmotic drug solution 20 shown in the image It is configured to extract a shape.
The sharpness detection unit 2b3 is provided in an endoscope main body (not shown), and the sharpness of the contour shape of the droplet of the osmotic chemical solution 30 extracted by the image processing unit 2b2, for example, the contour portion of the droplet It is configured to detect in several stages according to the contrast between the image and its surroundings.
Therefore, according to the penetration degree detecting unit 2 configured as shown in FIG. 3, when the contrast between the contour portion of the droplet and its surroundings becomes weak and the sharpness becomes a predetermined value or less, the inner wall of the living body lumen It can be detected that the penetration degree of 30 internal tissues has reached a predetermined degree.

  The spray operation control unit 3 is provided in an endoscope main body (not shown), and has a predetermined degree of penetration of the osmotic drug solution 20 detected by the penetration degree detection unit 2 into the internal tissue of the living body lumen inner wall 30. When the degree is reached, the operation of the chemical spray unit 1 is controlled so that the chemical spray unit 1 sprays the osmotic chemical solution 20 onto the surface of the inner wall 30 of the living body lumen.

  The observation optical system 4 is provided at the endoscope distal end 10 so that an image of the inner wall 30 of the living body lumen can be obtained via an eyepiece (not shown) or the imaging unit 2b1 as shown in FIG. It is configured.

The state change detection unit 5 is provided in an endoscope main body (not shown), and a living body obtained through the observation light optical system 4 of the endoscope (further, the imaging unit 2b1 as shown in FIG. 3). A change in the state of the internal tissue of the biological lumen inner wall 30 is detected from the image of the lumen inner wall 30 based on, for example, a change in the transparency or color of the biological lumen inner wall 30 shown in the image.
Further, the spray operation control unit 3 further, when the state change of the internal tissue of the living body lumen inner wall 30 detected by the state change detection unit 5 reaches a predetermined state, the living body of the osmotic drug solution 20 by the drug solution spray unit 1. The operation of the chemical solution spray unit 1 is controlled so as to finish spraying on the surface of the lumen inner wall 30.

In addition, in the osmotic chemical | medical solution administration system of this embodiment, you may provide the spray instruction | indication part 3 'instead of the spray action control part 3 shown in FIG.1 (b).
The spray instructing unit 3 ′ penetrates the medicinal solution spray unit 1 when the degree of penetration of the osmotic chemical solution 20 detected by the penetration degree detecting unit 2 into the internal tissue of the inner wall 30 of the living body lumen reaches a predetermined level. It is configured to instruct spraying of the sex drug solution 20 onto the surface of the inner wall 30 of the living body lumen.
The spray instruction in the spray instructing unit 3 ′ is performed by, for example, displaying a spray instruction message on a display screen of a display device connected to an endoscope main body (not shown), blinking light using an LED, or a sound generating device. It is preferable to use a means for stimulating the visual and auditory senses of the operator, such as the output of the voice used.
In the case of the configuration including the spray instruction unit 3 ′, the operator sprays the surface of the inner wall 30 of the osmotic chemical solution 20 by the chemical solution spray unit 1 every time the spray instruction unit 3 receives a spray instruction. Do it manually.

The osmotic drug solution administration procedure to the administration target site (here, the surface of the affected part 30a of the living body lumen inner wall 30) using the osmotic drug solution administration system of the present embodiment configured as described above is shown in FIG. I will explain. FIG. 4 shows details of a procedure for administering a clearing solution that requires a sufficiently long time and a sufficient amount of drug solution, in particular, than the penetration into living tissue.
First, the operator inserts an endoscope into the inner wall 30 of the living body lumen and searches for an affected part 30a existing on the inner wall 30 of the living body lumen (step S1).
After confirming the position of the affected part 30a, the operator inserts a spraying device (medicine spraying part 1) of the clearing liquid (penetrating drug solution 20) from the forceps channel of the endoscope (step S2).
Next, the operator directs the supply port 1b of the clearing liquid 20 in the spray device 1 toward the affected part 30a (step S3).
Thereby, the preparation for administering the clarification solution 20 to the affected part 30a of the inner wall 30 of the living body lumen is completed.
When the penetration degree detecting unit 2 is configured by the interferometer 2a using the optical fiber shown in FIG. 2, prior to the administration of the clearing solution 20, the probe unit 2a4 is directed to the affected part 30a, and the refractive index cross section. Start acquiring the profile.

Thereafter, the clearing solution 20 is administered to the affected part 30a of the inner wall 30 of the living body lumen according to the procedure shown in steps S4 to S7 below.
A part of the total dose of the clearing liquid 20 necessary to make the affected part 30a transparent is sprayed on the surface of the affected part 30a (step S4). Here, this step is defined as the first step. Here, since the clearing liquid 20 is often relatively viscous due to the composition and use concentration as described above, it can be said that the clearing liquid 20 easily adheres to the surface of a living tissue as compared with other chemicals, but mucus exists on the surface of the living tissue. Or the amount of adhesion may vary depending on the microstructure of the structure surface layer. Therefore, the permeation degree detection unit 2 sets the amount of adhesion that is the maximum permissible amount of the transparentizing liquid 20 to adhere to the tissue wall surface as the lower limit value of the permeation degree while confirming the spray amount at the target site. It may be set so that when the lower limit value is reached during the spraying operation, a warning for stopping the spray amount is issued, or the spraying operation is stopped.
After spraying, the spraying operation of the clearing liquid 20 by the spray device 1 is stopped, and the clearing liquid on the surface of the affected part 30a until the degree of penetration of the clearing liquid 20 into the internal tissue of the affected part 30a reaches a predetermined degree. 20 spraying is made to stand by (step S5, step S6). Here, this step is the second step.
When the degree of penetration of the clearing liquid 20 into the internal tissue reaches a predetermined level and the state change of the internal tissue of the affected part 30a has not reached the predetermined state, it is the first step shown in step S4. Spraying of the clearing liquid 20 and the second step shown in Step 5, the surface of the affected part 30 a until the degree of penetration of the clearing liquid 20 into the internal tissue of the affected part 30 a reaches a predetermined degree Repeat spraying and waiting. On the other hand, when the degree of penetration of the clarification liquid 20 into the internal tissue reaches a predetermined level and the state change of the internal tissue of the affected part 30a reaches a predetermined state, the spraying of the clarification liquid 20 is terminated (step S7). ).
Thereby, the clearing liquid 20 of the whole dose required for the clearing of the affected part 30a is administered, for example, at a timing as shown in FIG.

  Thereafter, the spray device 1 of the clearing liquid 20 is extracted from the forceps channel (step S8), and the operation is performed (step S9).

According to osmotic drug solution administration system of the present embodiment, a sufficient effect on the total dose of permeable chemical liquid 20 necessary to obtain the small portions plural times atomized droplets against body lumen wall 30 Therefore, the droplet of the osmotic chemical solution 20 is likely to stay on the surface of the inner wall 30 of the living body lumen. And even if the administration target site (affected part 30a) of the osmotic drug solution 20 on the inner wall 30 of the living body lumen is located at a position opposite to the gravity direction, the sprayed droplets of the osmotic drug solution 20 do not flow in the gravity direction. It can be administered stably.

Further, according to the osmotic drug solution administration system of the present embodiment, the time constant permeability drug solution 20 after spraying, by waiting for spray administration subject site located at a position contrary to the direction of gravity in the body lumen wall 30 The droplets of the osmotic drug solution 20 sprayed on the (affected part 30a) can be prevented from becoming large and flowing in the direction of gravity, and the osmotic drug solution 20 can be infiltrated into the internal tissue of the living body lumen inner wall 30.

Then, according to the osmotic drug solution administration system of the present embodiment, droplets gravity direction of the administration target site penetration chemical 20 were sprayed (affected area 30a) located at a position contrary to the direction of gravity in the body lumen wall 30 As a result, it is possible to supply the optimal amount of the osmotic drug solution 20 that is necessary to obtain a sufficient effect on the inner wall 30 of the living body lumen, and to suppress the loss of the osmotic drug solution 20. It is possible to eliminate the administration of the osmotic drug solution 20 to a healthy site where the administration of the osmotic drug solution 20 is unnecessary, and it is not necessary to give a burden to a healthy living tissue.

  In addition, according to the osmotic drug solution administration system of the present embodiment, the drug solution spraying unit sprays the osmotic drug solution 20 onto the surface of the inner wall 30 of the living body lumen from the side of the endoscope distal end 10. Therefore, the visual field of the administration site of the drug solution is not hindered, for example, as in the configuration using a balloon for sustained release of the drug solution and the drug sustained release stent described in WO2009 / 031295. For this reason, the osmotic drug solution 20 can be administered while confirming the effect at the administration site (affected part 30a) in the inner wall 30 of the living body lumen.

Therefore, according to the osmotic drug solution administration system of the present embodiment, to reduce the burden and work load on the living body, it is possible to omit the loss of the chemical as possible with respect to the administration subject site present in position against the force of gravity However, it is possible to adjust the optimal amount in a state where the drug solution is stably placed, and the osmotic drug solution can be administered while checking the effect of the drug solution without interfering with the visual field of the administration site. administration system is obtained.

  Further, in the osmotic drug solution administration system of the present embodiment, as shown in FIG. 1B, the osmotic drug solution 20 detected by the penetration level detection unit 2 penetrates into the internal tissue of the inner wall 30 of the living body lumen. When the degree reaches a predetermined degree, a spray operation control unit 3 that controls the operation of the chemical spray unit 1 is provided so that the chemical spray unit 1 sprays the osmotic chemical solution 20 onto the surface of the inner wall 30 of the living body lumen. Then, the optimal timing for spraying the osmotic chemical solution 20 via the chemical spray unit 1 can be easily obtained, and the osmotic drug solution 20 can be automatically sprayed at the optimal timing. It is possible to reduce the burden on the operator by eliminating the trouble of manually operating the operation of the spraying unit 1 and the confirmation of the spraying instruction.

  Further, in the osmotic drug solution administration system of the present embodiment, when the penetration level of the osmotic drug solution 20 detected by the penetration level detection unit 2 into the internal tissue of the inner wall 30 of the living body lumen reaches a predetermined level, If the spray instructing unit 3 ′ for instructing spraying of the osmotic chemical solution 20 onto the surface of the inner wall 30 of the living body lumen by the medicinal solution spraying unit 1 is provided, the operator's work can be saved without having to confirm the spray instruction by the operator. The burden can be reduced.

  Moreover, in the osmotic chemical solution administration system of the present embodiment, if the penetration degree detection unit 2 is configured by an interferometer 2a using an optical fiber as shown in FIG. Is mixed with the body fluid on the surface of the inner wall 30 of the living body lumen, and the permeation of the osmotic drug solution 20 from the observation image becomes difficult to determine the degree of penetration into the internal tissue of the inner wall 30 of the living body lumen. The change in the optical path length of the signal light based on the difference in refractive index between the sex drug solution 20 and the surface of the living body lumen inner wall 30 and the body fluid adhering to the surface of the living body lumen inner wall 30 is obtained by combining the signal light and the reference light. Since it can be distinguished as the difference in intensity of the waved light, the degree of penetration of the osmotic chemical solution 20 into the internal tissue of the inner wall 30 of the living body lumen can be accurately detected.

  Further, in the osmotic drug solution administration system of the present embodiment, as shown in FIG. 3, the penetration degree detection unit 2 is provided on the surface of the inner wall 30 of the living body lumen obtained through the observation optical system 4 of the endoscope. An image capturing unit 2b1 that captures an image, an image processing unit 2b2 that extracts a contour shape of a droplet of the sprayed osmotic chemical solution 20 in an image of the surface of the inner wall 30 of the living body lumen captured by the image capturing unit 2b1, and an image processing unit If the sharpness detection unit 2b3 that detects the sharpness of the contour shape of the osmotic chemical liquid droplet extracted in 2b2 is provided, a member for detecting the penetration degree is newly added to the endoscope distal end portion 10. There is no need to provide it. For this reason, the endoscope front-end | tip part 10 can be restrained as much as possible, and the penetration | invasion degree of the permeable chemical | medical solution 10 can be detected now also with respect to the biological lumen inner wall 30 with a small diameter.

  Further, in the osmotic drug solution administration system of the present embodiment, as shown in FIG. 1 (b), the living body lumen is obtained from the image of the inner wall 30 of the living body lumen obtained through the observation optical system 4 of the endoscope. The state change detection unit 5 that detects the state change of the internal tissue of the inner wall 30 has a predetermined state in which the state change of the internal tissue of the living body lumen inner wall 30 detected by the state change detection unit 5 If the operation of the drug solution spraying unit 1 is controlled so that the spraying of the osmotic drug solution 20 onto the surface of the inner wall 30 of the living body lumen by the drug solution spraying unit 1 is terminated, the operator's It is possible to administer an optimal amount of the osmotic drug solution to the inner wall 30 of the living body lumen while reducing the work load while preventing excessive administration.

Having described the embodiments of the osmotic drug solution administration system of the present invention, permeable chemical liquid administration system of the present invention is not limited to the configuration of the above embodiment.
For example, in the present invention, the term “endoscope” is used on a display for a treatment instrument for internal use that is not an observation purpose such as a catheter when it has a means for detecting the penetration state of a penetrating drug. This is a broad sense including the case of displaying distribution data relating to the observable penetration state.
Further, in the second step, the spray amount is set not to completely stop the spraying of the osmotic chemical solution 20 by the chemical spray unit 1 but to spray a small amount of the osmotic chemical solution 20 compared to the first step. You may comprise the spray action control part 3 so that it can adjust for every process.
In addition, the state change detection unit 5 is not limited to the above-described example, and may be any means that recognizes that the state of the surface of the living tissue is in a different state depending on the presence or absence of the osmotic chemical solution 20 or the amount of adhesion by spraying. Other means (for example, an ultrasonic sensor for detecting a liquid level, an electrode for impedance measurement) may be used.
Further, the spray operation control unit 3 is configured so that the spray amount of the osmotic chemical solution 20 by the chemical solution spray unit 1 can be adjusted according to the state change of the internal tissue of the inner wall 30 of the living body lumen detected by the state change detection unit 5. May be.
Further, when the penetration time into the internal tissue of the living body lumen inner wall 30 with respect to the spraying of the predetermined amount of the osmotic chemical solution 20 is roughly known, the penetration degree detection unit 2 is configured by a timer, and every predetermined time has elapsed. The osmotic chemical solution 1 may be sprayed.
Further, permeable chemical liquid used in the osmotic drug solution administration system of the present invention is when a transparent solution is the most effective, as long as the drug solution having a permeability and efficacy to the living tissue, staining solution, It may be a contrast medium, or may be a restoration solution such as phosphate buffered saline (PBS) used when the affected area is made transparent and then returned to the original opaque state.

Permeable chemical liquid administration system of the present invention, all areas in the affected area that exists in a direction against gravity, administered permeability chemical such as transparency solution, it is required to diagnose or treat the affected area after administration Useful for.

DESCRIPTION OF SYMBOLS ₁ Chemical spray part 1a Supply path 1b Supply port 2 Penetration degree detection part 2a Interferometer 2a1 using optical fiber Light source part 2a2 Fiber coupler 2a3 Reference light reflection system 2a3 ₁ Lens 2a3 ₂ Mirror 2a3 ₃ Mirror drive part 2a4 Probe part 2a4 ₁ Lens 2a5 Light detection unit 2a6, 2a7, 2a8, 2a9 Single mode fiber 2b1 Imaging unit 2b2 Image processing unit 2b3 Sharpness detection unit 3 Spray operation control unit 3 'Spray instruction unit 4 Observation optical system 5 State change detection unit 10 Endoscope Tip 11 Flexible member 20 Osmotic drug solution 30 Body lumen inner wall 30a Affected part

Claims (6)

An osmotic drug solution administration system for administering an osmotic drug solution to an inner wall of a living body lumen using an endoscope,
A medicinal solution spraying part configured to be able to spray the penetrating medicinal solution on the surface of the inner wall of the living body lumen from the side of the endoscope distal end part;
An infiltration degree detection unit for detecting the degree of penetration of the osmotic chemical solution sprayed onto the surface of the inner wall of the biological lumen by the medicinal solution spraying unit;
A first step of spraying the osmotic chemical solution onto the surface of the inner wall of the living body lumen by the medicinal solution spraying unit; and the biological tube of the osmotic drug solution detected by the permeation degree detecting unit after the first step. A second step of waiting for spraying of the osmotic chemical liquid onto the surface of the inner wall of the living body lumen by the chemical liquid spraying section until the degree of penetration into the internal tissue of the lumen inner wall reaches a predetermined level; An osmotic drug solution administration system, which is alternately repeated, and a predetermined amount of the osmotic drug solution is intermittently administered to the inner wall of the living body lumen in a plurality of times.   Furthermore, when the degree of penetration of the osmotic drug solution detected by the penetration degree detection unit into the internal tissue of the inner wall of the living body lumen reaches a predetermined level, the drug solution spraying unit transfers the osmotic drug solution to the The medicinal-solution administration system according to claim 1, further comprising a nebulization operation control unit that controls the operation of the medicinal-solution spraying unit so as to spray onto the surface of the inner wall of the living body lumen.   Further, when the degree of penetration of the osmotic drug solution detected by the penetration level detection unit into the internal tissue of the inner wall of the living body lumen reaches a predetermined level, the osmotic drug solution by the drug solution spray unit is The medicinal-solution administration system according to claim 1, further comprising a spray instructing unit that instructs spraying on a surface of the inner wall of a living body lumen.   The medicinal solution administration system according to any one of claims 1 to 3, wherein the permeation degree detection unit includes an interferometer using an optical fiber. The penetration degree detecting unit picks up an image of the surface of the inner wall of the living body lumen obtained through the observation optical system of the endoscope, and the surface of the inner wall of the living body lumen taken by the imaging unit The image processing unit for extracting the contour shape of the droplet of the osmotic chemical solution reflected in the image, and the definition of the contour shape of the droplet of the osmotic chemical solution extracted by the image processing unit. It has a sharpness detection part to detect,
4. The sharpness detected by the sharpness detection unit is a degree of penetration of the osmotic chemical solution into an internal tissue of the inner wall of the living body lumen. Chemical solution administration system. And a state change detection unit that detects a state change of the internal tissue of the inner wall of the living body lumen from an image of the inner wall of the living body lumen obtained through the observation optical system of the endoscope,
When the state change of the internal tissue of the inner wall of the living body lumen detected by the state change detecting unit reaches a predetermined state, the spray operation control unit is configured so that the living body lumen of the osmotic drug solution by the drug solution spraying unit is 6. The medicinal solution administration system according to claim 2, wherein operation of the medicinal solution spraying unit is controlled so as to finish spraying on the surface of the inner wall. .

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