JPH0418567Y2 - - Google Patents

Description

[Detailed Description of the Invention] [Industrial Application Field] The present invention relates to a hysteroscope suitable for observing the inside of the uterus.

[Prior art] Hysteroscopes are used to observe the inside of the uterus, perform artificial insemination, tissue sampling, and other procedures.
Widely used in obstetrics and gynecology. Such a hysteroscope is equipped with a hysteroscope main body that is roughly composed of an insertion section into a body cavity and an operation section for manually operating the insertion section, and the insertion section can be moved in a desired direction. There are flexible hysteroscopes that can be bent and rigid hysteroscopes that have a rigid insertion section.

Here, the hysteroscope main body of the hysteroscope is equipped with various built-in parts, and these built-in parts include a light for transmitting illumination light toward the observation target area, as in a normal endoscope. In addition to having a light transmission path and an image transmission path for the area to be observed, as a built-in component unique to the hysteroscope, there is a device that is sent into the body cavity to inflate the inside of the body cavity in order to secure an observation field of view within the body cavity. It has a liquid feeding mechanism that pumps liquid. This liquid feeding mechanism consists of a liquid feeding channel that feeds the liquid into the body cavity, and a perfusion channel that perfuses the liquid sent into the body cavity. The opening is connected to a liquid feeding port at the distal end of the insertion portion by a liquid feeding channel, and the liquid feeding port is connected to piping from a liquid feeding tank. Further, as the irrigation channel, a treatment instrument insertion channel provided for inserting a treatment instrument such as forceps is used, and the arrangement is such that the irrigation fluid is guided from this treatment instrument insertion channel to the drainage tank.

When supplying liquid into the body cavity, the liquid stored in the liquid supply tank located at a higher place than the area where the hysteroscope is located is used to supply the operating part by the action of the water head pressure. The liquid is supplied to the liquid channel through the liquid port at a predetermined pressure, and the liquid is sent into the body cavity from the liquid feed port at the distal end of the insertion section. At the same time, the fluid inside the body cavity is perfused from the drainage section to the drainage tank via the treatment instrument insertion channel, and as a result, the fluid inside the uterus is circulated and kept clean. The observation field of view can be improved, and the inside of the uterus can also be cleaned.

[Problems to be solved by the invention] By the way, in the hysteroscope of the prior art described above, when fluid is supplied into the body cavity from the fluid channel, there is a problem in the connection between the fluid channel and the perfusion channel. Due to the relationship of the flow path area and the contraction force of the uterus, even if you try to send fluid, it may not be possible to expand the inside of the body cavity and the fluid may flow out from the drainage part through the treatment instrument insertion channel. Therefore, there was an inconvenience that it was not possible to obtain a sufficient field of view in the area to be observed. Note that in order to reliably expand the inside of the body cavity, it is possible to increase the pressure of the liquid supplied from the liquid supply flow path, and for this purpose, a configuration may be used in which the liquid is pumped using a pump. However, if such a configuration is adopted, excessive fluid pressure may act, causing fluid to enter the fallopian tubes from the uterus, creating a very dangerous situation. Therefore, the supply liquid pressure itself cannot be increased. It is also possible to install a throttle valve in the drainage channel, but since body fluids and other filth mixed in with the perfusion fluid flow into this drainage channel, this filth may adhere to the throttle valve. , it will contaminate the throttle valve. In particular, if dirt gets into the space between the valve body of the throttle valve and the inner wall of the valve casing, sealing member, etc., it becomes almost impossible to remove the dirt, resulting in problems such as extremely poor cleaning performance.

The present invention was developed in view of the above points, and its purpose is to improve the ability to observe the inside of a body cavity without increasing the pressure during fluid delivery. To provide a hysteroscope that can be reliably inflated.

[Means for Solving the Problems] In order to achieve the above-mentioned object, the present invention includes a perfusion channel that includes a treatment instrument insertion channel and a drainage section that branches off the treatment instrument insertion channel in the middle. The liquid draining section is characterized by having a configuration in which a constriction section having a constriction plate having a flow channel area smaller in cross-sectional area than the liquid sending channel is removably attached. .

[Function] Since the drain section is provided with a throttle section having a throttle mechanism consisting of a throttle plate, the flow rate of the drained fluid is controlled by this throttle section with respect to the flow rate of the fluid supplied from the fluid supply tank into the body cavity. As a result, the liquid sent through the liquid sending channel stays in the body cavity, and the inside of the body cavity can be expanded. Furthermore, although the flow path is constricted, it is possible for the liquid to flow out from the drainage part, so that perfusion can also be performed and the liquid in the body cavity can be maintained in a clean state. In addition, the liquid supply tank is located at a predetermined height position, and the water head pressure based on the height position of this liquid supply tank is set as the maximum pressure, so abnormal pressure causes liquid to enter the body cavity. There is no risk of it being supplied, and safety is ensured. Although the discharge flow rate cannot be controlled on the constriction side that has a fixed constriction, a pressure adjustment mechanism is provided on the fluid supply side, so by operating this pressure adjustment mechanism, the fluid pressure in the body cavity can be adjusted. can be adjusted.

In addition, the diaphragm mechanism of the diaphragm part uses a diaphragm plate with a fixed diaphragm opening, which is removably attached to the drainage part. By detaching the constriction section, the constriction section can be cleaned by itself, making it extremely easy to clean it completely in a short period of time. Furthermore, by appropriately replacing and installing constriction sections with different flow path areas, the back pressure can be set to achieve an appropriate perfusion state depending on the patient to be examined.

[Example] Hereinafter, an example of the present invention will be described in detail based on the drawings.

First, FIG. 2 shows the overall configuration of the hysteroscope. In the figure, a hysteroscope main body 1 is roughly composed of an insertion section 2 inserted into a body cavity and an operation section 3.As is clear from FIG. The spiral tube 2a is covered with a protective net 2b and then covered with a resin coating 2c, so that it can be bent in an appropriate direction.The tip portion is a hard tube. It has become 2d.

Then, the hard part 2 at the distal end portion of the insertion section 2
An illumination window 4 for illuminating the observation target part with illumination light and an observation window 5 for inputting an image from the observation target part are formed at d. One end of a light guide made of an optical fiber bundle for transmitting illumination light is connected to the illumination window 4, and this light guide is guided from the insertion section 2 to the light guide cable 6 via the operation section 3, and is connected to the light guide cable 6. The other end of the light guide cable is connected to a light source device.
Furthermore, an objective lens system is attached to the observation window 5, and one end of an image guide made of an optical fiber bundle for image transmission that is routed from the insertion section 2 to the operation section 3 is connected to the objective lens system. The other end of this image guide is connected to an eyepiece system attached to an eyepiece section 7 connected to the operation section 3. These light guides, image guides, and other structures are generally well known, so illustrations and detailed explanations thereof will be omitted.

In addition to the above-described illumination window 4 and observation window 5, a liquid feeding port 8 and a treatment tool outlet 9 are formed in the rigid tip portion 2d. As shown in FIG. 3, these liquid feeding port 8 and treatment instrument outlet 9 are connected to a liquid feeding channel 10 and a treatment instrument insertion channel 11, which are routed inside the insertion section 2, respectively. The other ends of the liquid channel 10 and the treatment instrument insertion channel 11 are extended to the operating section 3 and are connected to the liquid supply section 1.
2. Opens to the outside as a treatment instrument insertion section 13. These liquid feeding ports 8 and liquid feeding channels 1
0 and the liquid supply part 12, and the liquid supply part 12 is connected via a liquid supply tube 15 to a liquid supply tank 14 that stores liquid such as water in order to expand the inside of the body cavity. The liquid supply tank 14 is provided at a position a predetermined height higher than the position at which the hysteroscope body 1 is operated, in order to apply water head pressure to the liquid supply tank 14. In order to adjust the pressure of the liquid supplied from the liquid supply tank 14, a pressure regulating valve 16 for adjusting the liquid supply pressure is installed in the middle of the liquid supply tube 15.

On the other hand, the treatment instrument insertion channel 11 described above is
Not only does it have the function of inserting forceps and other treatment tools, but it can also be used to perfuse fluid supplied into the body cavity. For this purpose, a drainage section 17 is connected in the middle of the treatment instrument insertion channel 11, and the drainage section 17
, a treatment instrument outlet 9 and a treatment instrument insertion channel 1
1 to form a perfusion flow path. A check valve 18 is attached to the treatment instrument insertion section 13 in order to prevent the irrigation fluid from overflowing from the treatment instrument insertion section 13 when forming this irrigation channel.

As shown in FIG.
A T-shaped joint pipe 20 for forming a drainage flow path is attached to the pipe. Of the joint pipe 20, a horizontal pipe portion 20a facing in a direction parallel to the axis of the insertion portion 2 is housed in the treatment instrument insertion channel 11, and protrudes in a direction perpendicular to the horizontal pipe portion 20a. The vertical tube portion 20b penetrates the metal ring 19 and projects to the outside of the insertion portion 2. A connecting cap 2 is attached to the tip of the vertical pipe portion 20b.
1 is removably screwed onto the connecting cap 21, and a diaphragm plate 22 is integrally connected to the connecting cap 21. The throttle plate 22 includes a throttle channel 2 having a flow channel cross-sectional area smaller than the channel cross-sectional area in the liquid-feeding channel from the liquid-feeding channel 10 to the liquid-feeding port 8.
2a is formed. Furthermore, the connection cap 2
1, a drain tube 23 is removably connected to the drain tube 23 by a Luer lock method or the like, and a drain tank 2 is attached to the tip of the drain tube 23.
4 are now connected. In FIG. 1, reference numeral 25 indicates a sealing member interposed between the flange portion 20c formed on the joint pipe 20 and the metal ring 19.

As shown in FIG. 4a, the throttle channel 22a of the throttle plate 22 in the connection cap 21 described above has an opening of a predetermined diameter. As shown in Fig. 4b, a diaphragm plate 22' having a large number of small holes 22b', and as shown in Fig. 4c, a diaphragm member 2 with a mesh.
It can also be configured by 2'' or the like.

This embodiment is constructed as described above, and its operation will be explained next.

When inserting the insertion section 2 connected to the hysteroscope main body 1 into a patient's body cavity and observing the inside of the body cavity, it is first necessary to supply liquid to bulge the inside of the body cavity. Therefore, a liquid supply tube 15 connected to a liquid supply tank 14 placed at a predetermined high place is connected to the liquid supply part 12, and a liquid drain tube 23 connected to the liquid drain tank 24 is connected to a connection cap 21 in the liquid drain part. Link. In this state, the pressure regulating valve 16 sends out the liquid in the liquid supply tank 14 from the liquid supply tube 15 at a predetermined pressure. As a result, this liquid is transferred to the liquid supply section 12 which forms a liquid feeding channel;
The liquid is supplied into the body cavity from the liquid feeding port 8 through the liquid feeding channel 10 one after another. A portion of the liquid supplied in this way passes through the treatment instrument insertion channel 11 through the drainage channel consisting of the drainage section 17, and is perfused into the drainage tank 24 via the drainage tube 23.

A throttle plate 22 is interposed in the middle of the perfusion channel of the joint pipe 20 in the drain section 17, and the cross-sectional area of the throttle channel 22a in the throttle plate 22 is equal to the above-mentioned supply flow path. Since the cross-sectional area of the fluid flow path is smaller than that of the fluid flow path, there is a difference between the fluid supply flow rate and the fluid drainage flow rate, and due to the back pressure on the drainage side caused by this flow rate difference, the fluid is kept inside the body cavity. remains.
As a result, the inside of the body cavity is expanded by a predetermined amount, making it possible to obtain a wide field of view within the body cavity.

In this way, the liquid supply pressure is adjusted to the liquid supply tank 14.
Since the upper limit is set to the water head pressure based on the height position of Even if the valve 16 is fully opened, this upper limit pressure will not be exceeded, and therefore, dangerous situations such as abnormal pressure acting and fluid flowing from the uterus into the fallopian tubes, etc., are prevented from occurring. can do.

As mentioned above, fluid is supplied into the body cavity,
When the inside of the body cavity expands and reaches a predetermined pressure state, a certain hydraulic pressure balance will occur between the body cavity and the fluid delivery channel and drainage channel, The amount of fluid discharged from the drainage channel is supplied to the inside of the body cavity via the liquid sending channel.
As a result, a circulation flow is formed within the body cavity, and the inside of the body cavity is kept clean at all times, so that the inside of the body cavity is sufficiently expanded and the fluid in the body cavity is cleaned. By doing so, the field of view for observation becomes significantly better, and diagnosis etc. can be performed extremely smoothly. Moreover, this liquid supply also makes it possible to clean the inside of the body cavity.

Therefore, when inserting a treatment instrument such as forceps through the treatment instrument insertion channel 11, since there is no part formed in the treatment instrument insertion channel 11 where the passage becomes particularly narrow, the insertion operation of such a treatment instrument is difficult. Needless to say, this can be done smoothly. Moreover, the drainage part 17 is branched in the middle of the treatment instrument insertion channel 11, and the treatment instrument insertion part 13
When the treatment instrument is inserted through the check valve 18 attached to the body cavity, a circulating flow is formed to keep the inside of the body cavity clean and to provide a good observation field of view, allowing the appropriate treatment to be performed using the treatment instrument. I can do it.

By the way, there are cases where it is necessary to change the flow passage cross-sectional area of the throttle flow passage due to differences in patient constitution and operations for controlling the amount of expansion within the body cavity. The connecting cap 21 may be detached from the joint pipe 20 and replaced with a connecting cap having a flow passage cross-sectional area different from that of the throttle passage 22a of the throttle plate 22 of the connecting cap 21. In this way, the throttle channel 2 in the throttle plate 22
Although the flow path area of 2a is fixed, since a pressure regulating valve 16 is provided on the liquid supply side, this pressure regulating valve 16 exhibits the function of regulating the pressure inside the body cavity.
Therefore, the inside of the body cavity can be expanded to an optimal state very easily.

In addition, the hysteroscope must be cleaned each time it is used, but the irrigation channel from the treatment instrument insertion channel 11 through which body fluids and other contaminants pass to the drainage section 17 must be particularly carefully cleaned to completely remove contaminants. must be removed. When performing this cleaning, the connecting cap 21 screwed onto the vertical pipe section 20b of the joint pipe 20 is removed, and the connecting cap 21 and the drain tube 23 are separated to form a constriction section. The connecting cap 21 can be cleaned independently. Moreover, since this connecting cap 21 is a fixed diaphragm mechanism formed by drilling an opening with a predetermined diameter in the diaphragm plate and attaching a mesh, cleaning of this diaphragm part is extremely easy. Moreover, it is possible to completely remove dirt, etc. in a short period of time.

In each of the above-described embodiments, a flexible hysteroscope is shown, but a rigid hysteroscope can also have a drainage section similar to that described above. Further, although the treatment instrument insertion channel is used as the irrigation channel, the irrigation channel may be provided separately from the treatment instrument insertion channel. Furthermore, the constriction section provided in the drain section is
It can also be formed by a fixed aperture. moreover,
Although the drainage part is installed in the insertion part of the hysteroscope main body, it goes without saying that it can also be installed in the operation part.

[Effects of the invention] As described in detail above, according to the invention, since the drainage part constituting the perfusion channel is provided with a constriction part, it is possible to reliably supply fluid to the inside of the body cavity. It is now possible to inflate to the desired degree, and as a hysteroscope, a sufficient field of view can be obtained.Moreover, the liquid supply pressure is a function of the water head pressure based on the height position of the liquid supply tank. Since the fluid is regulated by It is also possible to take appropriate measures, and furthermore, this constriction section can be formed by a fixed constriction plate with a flow channel cross-sectional area smaller than that of the liquid sending channel, and this is removably attached to the liquid drainage section. With this structure, after using the hysteroscope, if the constriction part is attached and detached from the drainage part, the hysteroscope can be cleaned very easily and completely in a short period of time.

[Brief explanation of the drawing]

Figures 1 to 4 show the first embodiment of the present invention, with Figure 1 being a sectional view of the drainage section, Figure 2 being the overall configuration of the hysteroscope, and Figure 3 being the fluid delivery and drainage section. FIGS. 4a, 4b, and 4c are explanatory views showing the configurations of different types of aperture parts, respectively. DESCRIPTION OF SYMBOLS 1...Hysteroscope main body, 2...Insertion section, 3...Operation section, 8...Liquid feeding port, 9...Treatment instrument outlet, 10...
...Liquid feeding channel, 11...Treatment instrument insertion channel, 12...Liquid supply section, 14...Liquid supply tank, 1
7, 30... Drainage section, 20, 31... Joint piping,
21...Connection cap, 22, 22', 22''...
Throttle plate, 22a... throttle channel, 22a'... small hole.

Claims (1)

[Scope of Claim for Utility Model Registration] (1) For feeding a liquid to inflate the inside of a body cavity into a hysteroscope body that is equipped with an insertion section into a body cavity and an operation section for manually operating the insertion section. A liquid supply channel is connected to the pipe of a liquid supply tank installed at a predetermined height, and a pressure adjustment mechanism is provided in the middle, and the liquid sent into the body cavity by the liquid supply channel is connected to In a hysteroscope provided with an irrigation channel for perfusing water, the irrigation channel is formed by a treatment instrument insertion channel and a drainage part where the treatment instrument insertion channel is branched midway; The hysteroscope is characterized in that a diaphragm portion having a diaphragm plate having a flow passage cross-sectional area smaller than that of the liquid feeding passage is removably attached thereto. (2) The throttle section is formed by a cap member that is removably attached to the liquid drainage section, and the cross-sectional area of the flow path of the throttle section can be changed by replacing the cap member. The hysteroscope according to claim (1) of the utility model registration claim, characterized in that: