JPH03149022A - Endoscope device - Google Patents

Abstract

PURPOSE:To protect the top edge part of an endoscope from bad influence when therapy is carried out by allowing a shock wave generating probe to be equipped with a probe inserting means which controls the insertion quantity on the basis of the output of a projection quantity detecting means in order to obtain the prescribed quantity of the projection quantity in a clamp channel. CONSTITUTION:The insertion part 3 of an endoscope body 1 is inserted into a body, and the top edge part 4 is directed to an observed part such as concretion 17, etc. When a probe insertion device 8 is operated, a roller revolves to insert a probe 7 into the clamp channel 5 of the endoscope body 1. The probe 7 projects forward from an opened port part 5a, and when a prescribed projection quantity is obtained, the irradiation light irradiated from a luminous element 19 is reflected by the top edge part 7a, and the reflection light is inputted into a light receiving element 20, and the signal is inputted into a probe insertion device 8, which stops the revolution of the roller, and the probe 7 is set at the position in a prescribed projection quantity from the top edge part 4. The projection position is the position where shock waves do not exert bad influence to the endoscope top edge part 4.

Description

DETAILED DESCRIPTION OF THE INVENTION [Field of Industrial Application] The present invention relates to an endoscope device that emit shock waves from the distal end of an insertion portion to crush stones and the like in a body cavity. [Prior Art] In recent years, a technique has been developed to remove stones existing in body cavities such as the urinary tract and bile duct by applying shock waves to the stones and crushing them. That is, a probe having two electrodes arranged at its tips with a gap is inserted into a forceps channel of an endoscope, and the tip of the probe is brought close to a stone in the body cavity. Then, a high voltage is applied between the two electrodes to cause an electric discharge, and the shock wave caused by this electric discharge is applied to the stone, thereby crushing the stone. [Problems to be Solved by the Invention] However, lenses for the illumination optical system and the observation optical system are disposed at the tip of the endoscope, and when the probe tip is close to the endoscope tip, shock waves are generated. If this occurs, the above-mentioned lens will be adversely affected by this shock wave, which will cause damage to the endoscope body, such as cracking of the lens or peeling of the adhesive at the tip of the lens. becomes. The present invention has been made in view of this problem, and it is an object of the present invention to provide an endoscope device in which the distal end of the endoscope is not adversely affected when performing treatment by generating shock waves. [Means and effects for solving the problem] The endoscope device according to claim 1 comprises an endoscope main body having a forceps channel and a shock wave generating section at the tip, and is inserted into the forceps channel to be inserted into the endoscope body. A shock wave generation probe that protrudes from the tip of the insertion section of the endoscope and generates a shock wave, a protrusion amount detection means that detects the amount of protrusion of the shock wave generation probe from the tip of the insertion section of the endoscope, and the shock wave generation probe The protrusion amount is set to a predetermined amount in the forceps channel (probe insertion means for controlling the insertion amount based on the output of the protrusion amount detection means), and the probe is inserted into the forceps channel. The shock wave generating probe is controlled so that it always protrudes a predetermined amount from the tip of the insertion section.The endoscope device according to claim 2 includes an endoscope main body equipped with a forceps channel, and a shock wave generating probe at the tip. a shock wave generating probe that is provided with a generating section and that is inserted into the forceps channel and protrudes from the tip of the insertion section of the endoscope to generate a shock wave; and the amount of protrusion of the shock wave generation probe from the tip of the insertion section of the endoscope. and a control means connected to the shock wave generating section of the shock wave generating probe to control the output of the shock wave generating section based on the output of the protrusion amount detecting means. The output of the shock wave generating section is controlled according to the amount of protrusion of the shock wave generating probe inserted into the channel. [Embodiments] Hereinafter, embodiments of the present invention will be described with reference to the drawings.First
The figure shows a schematic configuration diagram of an endoscope apparatus according to a first embodiment related to claim 1 of the present application. The endoscope main body l has an operating section 2. It has an insertion section 3 and a channel 5 that opens from the operating section 2 through the insertion section 3 to the distal end section 4 . This channel 5 has an EHL device (
An EHL probe 7 connected to the electro-hydraulic fracturing device) 6 can be freely inserted and removed, and this EHL probe 7 is automatically inserted into the channel 5 by a probe insertion portion M8. Here, at the tip of the EHL probe 7, two electrodes with a gap as a shock wave generating section are arranged facing each other, and the high voltage current generated from the EIL device 6 is discharged between the electrodes. It is designed to generate a shock wave. As shown in FIG. 2, the distal end portion 4 of the endoscope main body 1 is provided with a stepped portion 4a on its proximal end side, and an outer skin tube that covers the external cause of the insertion portion 3 is attached to the stepped portion 4a. The distal end of 3a is fitted, and an observation hole 9 is formed therethrough in the axial direction. This observation hole 9 has a lens frame 1
A first objective lens lla is fixed to the observation hole 9 through the lens 0, and a second objective lens llb is directly fixed to the observation hole 9 opposite to the first objective lens lla. ing. A force bar glass llc is disposed on the tip side of the first objective lens lla, and the tip side of this force bar glass llc is exposed at the end surface of the tip portion 4. In addition, these, the first and second objective lenses lla, llb
An objective optical system 11 is composed of a power bar glass llc and a power bar glass llc. An image guide 13 fixed to the observation hole 9 is opposed to the base end side of the second objective lens llb via a base 13a. The base end side of the image guide 13 extends to an eyepiece provided in the operation section 2, and an image of the region to be observed, etc. formed by the objective optical system 11 is transmitted to the eyepiece. It looks like this. Further, a forceps channel 5 is formed through the tip portion 4 in parallel with the axis. The diameter of the proximal end of the forceps channel 5 is increased, and a cap 15 is attached to this increased diameter portion.
One end of the forceps tube 15 is fixed via a. The other end of the forceps chain 15 is communicated with a forceps insertion port opened on the distal end side of the scraping section 4, and when the probe 7 is inserted through the forceps insertion port, the probe 7 passes through the forceps tube 15 and passes through the forceps insertion port. The forceps channel 5 is guided to the tip portion 4, and protrudes from an opening 5a of the forceps channel 5, which is opened at the end face of the tip portion, so as to be able to move forward and backward. Two electrodes disposed with a predetermined gap are exposed forward at the tip 7a of the probe 7, forming shock wave generating means. These two electrodes are E
It is designed to be connected to a high voltage generation circuit provided in the HL main body 6, and when the high voltage generated by this high voltage generation circuit is applied between the two electrodes, a shock wave 1 is generated between the two electrodes.
6 is generated, and the structure is such that the stone 17 can be crushed by this shock wave 16. Further, the tip portion 4 has an opening 5a of the forceps channel 5.
Two holes 18a, 18b are bored adjacent to the. A light emitting element 19 is placed at the bottom of one hole 18a, and a light emitting element 19 is placed at the bottom of one hole 18a.
A light receiving element 20 is disposed at the bottom of the hole 8b, and both holes 18
By arranging the light emitting elements 19.a and 18b obliquely with respect to the axial direction, the light emitting element 19. The light receiving element 20 faces the direction of the probe 7 protruding from the opening 5a. This light emitting element 19
．． The light-receiving element 20 is connected to the probe insertion device 8, the light-emitting element 19 emits light due to the current from the probe insertion device 8, and the output signal from the light-receiving element 20 is input to the probe insertion device 8. , the light emitting element 19 and the light receiving element 2
0 constitutes a protrusion amount detection means 21 of the probe. The probe insertion device 8 has two rollers, which are rotated by a motor (not shown) to push and pull the probe 7 within the forceps channel 5. The probe insertion portion f8 receives a signal from the light receiving element 20, and the light emitted from the light emitting element 19 and reflected at the tip 7a of the probe 7 enters the light receiving element 20. The forceps channel 5 is configured to push the probe 7 into the forceps channel 5 until the incident light is detected. Next, the operation of this embodiment will be explained. When crushing a stone with the endoscope apparatus of this embodiment, - the insertion section 3 of the endoscope main body 1 is inserted into the body cavity, and the distal end section 4 is directed toward the site to be observed, such as the stone 17; This image of the region to be observed is guided to the eyepiece section in the operation section 2 by the observation optical system 11 and the image guide 13. When the probe insertion device 8 is operated in this state, the rollers rotate, thereby inserting the probe 7 into the forceps channel 5 of the endoscope body 1. This probe insertion device 8 simultaneously energizes the light-emitting element 19 provided at the tip 4 and opens the opening 5 of the forceps channel 5.
Light is irradiated in front of a. When the probe 7 protrudes forward from the opening 5a and reaches a predetermined protrusion amount, the light emitted from the light emitting element 19 is reflected by the tip 7a of the probe 7, and the reflected light is incident on the light receiving element 2G. Ru. The signal from this light receiving element 20 is input into the probe insertion device 8, and when the probe insertion device 8 detects the reflected light from the tip 7a of the probe 7, it stops the rotation of the roller. 4 to a position with a predetermined protrusion amount. This protruding position is set so that when a shock wave is generated by causing an electric discharge between the electrodes of the tip 7a of the probe 7, the shock wave does not adversely affect the tip 4 of the endoscope. It is a prominent position. Here, while observing the eyepiece, the tip of the probe 7a is placed to face the calculus 17, and the EHL main body 6 is operated to apply high voltage between the electrodes at the tip of the probe 7. This generates an electric discharge between the electrodes, and the resulting shock wave is emitted mainly toward the front of the probe 7, crushing the calculus 17. Even if the probe 7 is pushed back into the forceps channel 5 due to the impact during this discharge, there will be no reflected light that will enter the light receiving element 20 again, so the probe insertion device 8 will detect this and return it to the above-mentioned predetermined position. Also, the probe 7 is caused to protrude, and the amount of protrusion of the probe 7 is always kept constant. Therefore, the shock wave from the tip of the probe 7 has an adverse effect on the tip 4 of the endoscope 1, for example, the lens frame 1 of the observation optical system 11.
It does not cause adhesive peeling or lens cracking. According to this embodiment, the protrusion amount detection means 21 consisting of the light emitting element 19 and the light receiving element 20 is provided at the end of the endoscope, and the probe insertion means is controlled based on the output of this detection means, so that the probe is always inserted into the endoscope. It can be made to protrude a predetermined amount from the tip. Next, a second embodiment related to claim 2 will be explained based on FIG. Note that the same components as those in the first embodiment are given the same reference numerals, and the description thereof will be omitted. In this embodiment, there is no probe insertion device, and the operator manually inserts the probe 7 into the forceps channel 5 of the endoscope body 1. A protrusion amount detection means 21 consisting of a light emitting element 19 and a light receiving element 20 provided at the distal end 4 of the endoscope insertion section 3 is connected to the EHL device 6. The EHL device 6 is activated when there is an output from the light receiving element 20, that is, when there is an output from the light emitting element 19.
A high voltage can be applied to the electrode at the tip 7a of the probe 7 only when the light from the probe 7 is reflected by the tip 7a of the probe 7 and is incident on the light receiving element 20. In this embodiment configured as described above, discharge is possible only when the probe 7 is protruded from the tip 4 of the endoscope insertion part to an appropriate position, and the probe 7 is inserted into the endoscope. When the distal end 4 of the probe 7 is in close proximity to the distal end 4 of the probe 7, no electrical discharge occurs and there is no adverse effect on the distal end 4 of the endoscope during stone fragmentation.
When a was in forceps channel 5 of the endoscope, E was accidentally
Even when the HL device is operated, no discharge occurs and there is no risk of damaging the forceps channel of the endoscope. Next, the above 1. The protrusion amount detection means in the second embodiment will be described as a third embodiment based on FIG. 4. In the embodiment shown in FIG. 4, a repeating pattern of high reflectance parts and low reflectance parts is provided in the axial direction on the outer periphery of the EHL probe 30, and correspondingly, the forceps channel 5 of the endoscope body 1 is provided with a repeating pattern of high reflectance parts and low reflectance parts. A light emitting element 31 and a light receiving element 32 are provided. The light receiving element 32 receives the reflected light from the probe 30, and the light receiving element 32 is connected to the amplifier 33. It is connected to a counter 35 via a waveform shaping circuit 34. This counter 35 is connected to the EHL device and allows the EHL device to operate only when the count is within a predetermined range. Further, when applied to an endoscope apparatus equipped with a probe insertion device as in the first embodiment, the counter 35 is connected to the probe insertion device to control the amount of probe insertion as in the first embodiment. You may also do so. In this embodiment configured in this way, the probe 3
When 0 is inserted, light is emitted from the light emitting element 31 and the probe 30
The light reflected by the outer peripheral surface of the light receiving element 32 is received by the light receiving element 32. As the probe 30 moves, a pulse-like output is generated from the light receiving element 30, and the amplifier 33. After being amplified and waveform-shaped by the waveform shaping circuit 34, the pulses are input to the counter 35, and the counter 35 can count the pulses and detect the amount of protrusion of the probe. Based on this count value, EHL
An enable signal can be sent to the device to control whether output is allowed or prohibited, or can be used as a signal to control the amount of probe inserted by the probe insertion device. FIG. 5 shows a fourth embodiment, in which the endoscope main body l
A coil 36 is embedded in the inner peripheral surface on the distal end side of the forceps channel 5 in the insertion portion 3 . Then, the EHL probe 37 is inserted into the forceps channel 5. The tip 37a of this probe 37 is made of a metal tip whose outer periphery is coated with a magnetic material. The coil 36 is connected to an amplifier 39 in the EHL device 38, and this amplifier 39 has an output circuit that generates a high voltage to be output to the EHL probe 37! It is connected to an output control circuit 41 that controls 40. In this embodiment configured in this manner, when the probe 37 is moved, electromagnetic induction occurs in the coil 36, a voltage is generated, and the output of the EHL device 38 is controlled based on this voltage. In other words, shock waves are prevented from being generated when the probe 37 is close to the endoscope tip. 6 and 7 show a fifth embodiment applied to an electronic scope, in which the pattern of the captured image is detected and the probe 7 is
The EHL device is put into a movable state by detecting that the tip 7a of the forceps protrudes a predetermined amount from the forceps channel 5. 6th
As shown in the figure, signals from a CCD 41 provided at the tip of the endoscope are sent to an image processing circuit 42. This image processing circuit 42 detects the amount of protrusion of the probe 7 from the tip of the endoscope by using a method such as pattern matching on an endoscopic image as shown in FIG. When this image processing circuit 42 detects that the probe 7 has protruded by a predetermined amount, the EHL device 43
Sends an enable signal to Upon receiving this signal, EHL
The output control circuit 44 in the device 43 puts the output circuit 45 into a movable state. According to this embodiment, it is possible to detect the amount of protrusion of the probe without making any improvements to the endoscope body. The present invention is not limited to the above-described embodiments. For example, the protrusion amount detection means may detect that the shock wave generating part of the probe approaches the tip of the endoscope, and issue a warning such as a buzzer. You can. Further, as a second embodiment, generation of shock waves is prohibited when the shock wave generating part of the probe approaches the tip of the endoscope, and generation of shock waves is allowed when the probe is inserted to a predetermined protrusion amount. The shock wave generating section is controlled based on the output of the protrusion amount detection means. The output level of the shock wave may be controlled to be lowered when the shock wave approaches the tip. [Effect of the invention] Claim IEI! According to the invention, the probe is automatically inserted into the forceps channel of the endoscope so that the shock wave generating part at the tip of the shock wave generating probe protrudes a predetermined amount from the tip of the endoscope insertion part, so the operator can easily insert the probe into the forceps channel of the endoscope. Even if treatment is performed without worrying about the distance from the tip of the insertion section of the endoscope, shock waves will not have an adverse effect on the endoscope body. According to the invention as claimed in claim 2, the amount of protrusion of the shock wave generation probe from the tip of the insertion section of the endoscope is detected and the shock wave generation section is controlled based on the output. When adjusting the amount of insertion of the probe, depending on the amount of protrusion from the tip of the insertion tube, the shock wave generator may be unable to generate shock waves, or the output level of the shock wave may be lowered, causing shock waves to reach the endoscope body. No adverse effects.

[Brief explanation of the drawing]

FIG. 41 is a schematic configuration diagram of an endoscope device according to the first embodiment, FIG. 2 is a detailed view of the tip of the endoscope device according to the same embodiment, and FIG. 3 is a diagram of the endoscope device according to the second embodiment. A schematic configuration diagram of the mirror device, FIG. 4 is a configuration diagram of the main parts according to the third embodiment, FIG. 5 is a diagram of the main parts construction according to the fourth embodiment, and FIG. A main part configuration diagram, FIG. 7 is a diagram showing an observed image of the endoscope apparatus of the same embodiment. 1----------1 endoscope body, 5---------
−−−−−forceps channel 6−−−−−−−−−−
E HLi2 (IIm means) 7.
= E HL probe 8 --- Probe insertion means

Claims (2)

[Claims] (1) An endoscope body equipped with a forceps channel, a shock wave generation probe that is equipped with a shock wave generation section at its tip and that is inserted into the forceps channel and protrudes from the tip of the insertion section of the endoscope to generate a shock wave; a protrusion amount detection means for detecting an amount of protrusion of the shock wave generating probe from the tip of the insertion portion of the endoscope; An endoscope apparatus comprising: probe insertion means for controlling the insertion amount based on the output of the detection means; (2) an endoscope body equipped with a forceps channel; a shock wave generation probe that is equipped with a shock wave generation section at its tip and that is inserted into the forceps channel and protrudes from the tip of the insertion section of the endoscope to generate a shock wave; protrusion amount detection means for detecting the amount of protrusion of the shock wave generation probe from the tip of the insertion section of the endoscope; and the shock wave generation section is connected to the shock wave generation section of the shock wave generation probe and detects the amount of protrusion based on the output of the protrusion amount detection means. An endoscope device comprising: a control means for controlling the output of the endoscope.