JPH05285094A - Endoscope - Google Patents

Abstract

PURPOSE:To facilitate the rinsing of a pipeline, pump and the like for sucking smoke while allowing the removal of smoke caused by a laser cauterization keeping a celomic pressure constant. CONSTITUTION:At an inserting part 3 of an endoscope which allows the inserting of a laser probe 29 for cauterization treatment, an air feed pipeline 22 and a suction pipeline 23 are inserted therethrough having one end thereof opened at the tip part of the inserting part 3 and the other end thereof opened at an operating part 2 on the hand side. An air fed tube 31 communicating with an air feed pump 34 of a reflux device 33 and a suction tube 32 communicating with a suction pump 35 are mounted at an air feed port 27 of the air feed pipeline 22 and a suction port 28 of the air feed pipeline 23 respectively free to load or unload. The reflux device 33 sucks air with the suction pump 35 while the feeding of air the same in amount as the air sucked is performed with the air feed pump 34 thereby accomplishing a recirculation.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscopic device for ablation treatment by inserting a laser probe, a high frequency probe or the like, and an endoscope equipped with means for removing combustion smoke generated during the ablation treatment. Regarding a mirror device.

[0002]

2. Description of the Related Art Conventionally, a laser probe, a high-frequency probe, or the like is inserted into a treatment instrument channel of an endoscope to be inserted into a body cavity, and the probe is irradiated with a laser or the like to cauterize the target site. Cautery treatment is being performed.

When performing such an endoscopic cautery treatment, burning smoke is generated due to cauterization, and the burning smoke fills the body cavity, which obstructs the field of view of the observation optical system and causes the cauterization treatment site. There was a problem that it became invisible. If the ablation site is difficult to observe, erroneous laser irradiation or overirradiation may occur, increasing the risk to the patient.

Therefore, conventionally, in order to remove such burning smoke and maintain a good visual field, a device for suctioning from a suction conduit also serving as a treatment instrument channel, and JP-A-61-14 are used.
For example, a device for sucking combustion smoke while circulating is used as disclosed in Japanese Patent No. 1340.

[0005]

However, in a device that performs suction from the treatment instrument insertion port of the treatment instrument channel, since only suction is performed, the pressure in the body cavity decreases, and the body wall contracts. For this reason, the laser irradiation position changes, and accurate cauterization cannot be performed, which may cause erroneous irradiation or overcauterization.

Further, in an apparatus for performing suction of combustion smoke and laser irradiation while maintaining a constant pressure in the body cavity by performing recirculation, an air supply / suction pump provided in the endoscope control apparatus is used, and a small diameter is used. Due to long air supply and the use of a suction line, some problems occur.

That is, the amount of smoke produced by cauterization is
Since the ablation site varies depending on the ablation site, the built-in pump may not be able to sufficiently aspirate due to insufficient suction amount, but there is a problem that the pump cannot be easily replaced. In addition, although the pipeline and the inside of the pump become dirty due to smoke suction, it cannot be washed because the pump cannot be taken out, or the pipeline inside the endoscope is long, making it difficult to wash, and the cleaning cannot be performed reliably. It becomes unsanitary. In addition, since the flow path for reflux and suction is inserted through the endoscope to the proximal side, a thin flow path is used for a long section, and the resistance of the flow path is large and the suction effect is inferior to the pump capacity. There is a problem that you can not get it.

The present invention has been made in view of these circumstances. It is possible to reliably and sufficiently remove smoke caused by laser ablation while maintaining a constant pressure inside the body cavity, and to perform a reliable laser ablation. It is an object of the present invention to provide an endoscope device that can easily wash a conduit for sucking smoke, a pump, and the like, and can reliably remove stains on the conduit due to smoke suction.

[0009]

An endoscope apparatus according to the present invention is an apparatus having an endoscope capable of inserting a probe for cautery treatment in an elongated insertion portion, wherein the endoscope is Insert it through the insertion part and open one end at the tip of this insertion part,
The other end has a pipe line that opens to the operating portion on the near side, and has an intake means and an air supply means for supplying the same amount of air as the intake amount of the intake means, and communicates with the intake means. And an air supply passage communicating with the air supply means, which are detachably attached to or detachable from the conduit of the endoscope and are provided with a recirculation means for performing recirculation.

[0010]

The suction passage communicating with the suction means of the recirculation means with respect to the conduit which is inserted into the insertion portion of the endoscope and has one end opened to the distal end portion of the insertion portion and the other end opened to the operation portion on the proximal side. The passage and the air supply passage communicating with the air supply means are provided so as to be removable or insertable. The recirculation means performs intake by the intake means,
Recirculation is performed by supplying the same amount of air as the intake amount of the intake unit by the air supply unit.

[0011]

Embodiments of the present invention will be described below with reference to the drawings. 1 to 3 relate to a first embodiment of the present invention, FIG. 1 is an explanatory view showing a configuration of a main part of an endoscope apparatus, and FIG. 2 shows an end of an endoscope insertion portion from a direction A in FIG. FIG. 3 is a front view as viewed, and FIG. 3 is an explanatory diagram showing the configuration of the entire endoscope apparatus.

As shown in FIG. 3, the endoscope apparatus comprises an electronic endoscope 1, and the electronic endoscope 1 is provided with an operating portion 2 also serving as a grip portion on the hand side. The elongated insertion portion 3 is connected to the operation portion 2. The insertion portion 3 is provided with a distal end forming portion 4 which is harder from the distal end side, a bendable bending portion 5, and a flexible tube portion 6 having flexibility. A universal cord 7 is extended from a side portion of the operation portion 2, and is connected to the light source device 10 and the video processor 11 via connectors 8 and 9 provided at the end portion of the universal cord 7. There is. The video processor 11 includes a monitor 12 for displaying an endoscopic image, a VTR deck 13 for recording the image, a video printer 14, a video disk 15,
Also, a foot switch 16 for performing various instructions is connected.

Further, the operation section 2 of the endoscope 1 is provided with a treatment instrument insertion port 17 into which a laser probe or the like is inserted, and a reflux conduit connection section 18 to which a reflux device described later is connected.

The insertion portion 3 of the endoscope is provided with a treatment instrument channel 21, an air supply conduit 22, and an intake conduit 23,
Although not shown, a light guide fiber, a water supply pipe line, etc. are inserted. As shown in FIG. 2, the distal end constituent portion 4 of the insertion portion 3 is provided with a treatment instrument channel opening portion 21a, an air feeding conduit opening portion 22a, and an intake conduit passage opening portion 23a, and further, an observation window 24, this. A nozzle 25 for supplying water toward the observation window 24 and an illumination window 26 are provided. The treatment instrument channel 21, the air supply conduit 22, and the intake conduit 23 are inserted into the insertion portion 3 and the treatment tool insertion port 17 of the operation unit 2 and the air supply port 27 provided in the reflux conduit connection unit 18, respectively. It opens at the intake port 28. Treatment instrument channel 2
A laser probe 29 for performing cautery treatment can be inserted into the laser beam 1, and the laser probe 29 is connected to a laser device 30 for controlling the laser.

Although a cover made of plastic or the like is generally provided at the tip of the endoscope insertion portion 3 for electrical insulation, the surface of the cover is coated with ceramics so that a laser beam is emitted. This prevents the cover from melting due to the adhered pieces of hot meat flying from the cauterization part during cauterization.

In addition to the laser probe 29, the treatment instrument channel 21 can also be inserted with a high frequency probe or the like connected to a high frequency treatment device.

An air supply tube 31 and an air intake tube 32 are detachably connected to the air supply port 27 and the air intake port 28, respectively. The reflux device 33 is connected.
The reflux device 33 includes an air supply pump 34 and an intake pump 35, and the air supply pump 34 is connected to the air supply tube 31 and the intake pump 35 is connected to the intake tube 32. The air supply pump 34 and the intake pump 35 have the same air supply amount and intake amount, and are turned on at the same time by turning on a switch (not shown) provided in the recirculation device 33. That is, the recirculation device 33 can recirculate the gas in the vicinity of the treatment site in front of the insertion section 3 without changing the pressure inside the body cavity. Reflux device 33
Is disposed near the light source device 10 and the laser device 30, for example, and can be operated during observation and treatment.

Next, the operation of this embodiment will be described.
When performing laser ablation treatment using the endoscope 1, first, the laser probe 29 connected to the laser device 30 is inserted through the treatment instrument insertion port 17 through the treatment instrument channel 21, and the distal end portion of the distal end of the insertion portion 3 is inserted. The treatment tool channel opening 21a is projected. Then, laser irradiation is performed from the laser probe 29 to the ablation treatment site to perform ablation.

When the tissue is cauterized, combustion smoke is generated,
At this time, by operating the recirculation device 33 to recirculate, the combustion smoke is sucked and removed from the vicinity of the ablation treatment site. The reflux device 33 includes an air supply pump 34 and an intake pump 35.
And operate at the same time, and the amount of air sent and the amount of air taken in are the same,
At the same time that suction is performed from the intake pipe line 23 communicating with the intake pump 35, the same amount of air as that sucked by the intake pump 35 communicates with the air supply pump 34.
It starts from 2. Therefore, the pressure inside the body cavity near the ablation treatment site is kept constant.

Here, since the reflux device 33 is attachable / detachable to / from the endoscope operating section 2, it is possible to select and replace the air supply pump and the intake pump according to the cauterization site, such as when the suction amount is insufficient. is there. Further, the air supply tube 31 and the intake tube 32 can be made sufficiently thick so that the suction effect does not deteriorate.

After performing the laser ablation treatment, the air supply port 2
7, air supply tube 31 from intake port 28, intake tube 3
2 is removed, and the endoscope 1 and the reflux device 33 are separately washed. By separately washing as described above, the air supply conduit 22, the intake conduit 23, the air supply tube 31, the intake tube 32, the air supply pump 34, and the intake pump 35 in the endoscope insertion portion 3 can be easily cleaned. , The dirt of the pipes and the like due to the sucked combustion smoke is surely removed.

As described above, by providing a detachable recirculation device on the endoscope operation section, it is possible to suck and remove combustion smoke caused by laser cauterization, prevent obstruction of the field of view, and perform reliable laser cauterization. You can At this time, since the amount of inhalation and the amount of insufflation are the same, the pressure inside the body cavity can be kept constant, and erroneous laser irradiation can be prevented. Further, since the air supply conduit and the intake conduit provided in the endoscope are only inside the insertion portion and are short, they can be easily and reliably washed. Further, since the reflux device, the air supply tube, and the intake tube can be removed and easily washed, dirt on the pipe line or the like due to suction of combustion smoke can be surely removed.

4 and 5 relate to the second embodiment of the present invention. FIG. 4 is an explanatory view showing the structure of the main part of the endoscope apparatus, and FIG. 5 shows the treatment instrument insertion port of the endoscope operation section. It is sectional drawing which shows the structure of the reflux plug provided.

The second embodiment is an example in which inhalation or insufflation is performed by a treatment instrument channel through which a laser probe is inserted.

The endoscope 41 has a treatment instrument channel 43 for inserting a laser probe or various treatment instruments through an elongated insertion portion 42, and water supply for cleaning a lesion area to be observed and an observation window of the endoscope. And a front water supply channel 44 for performing the above. A rear portion of the front water supply channel 44 is opened at the operation portion 2, and a front water supply port body 45 is provided at the opening portion. That is, the air supply conduit 22 and the intake conduit 23 of the first embodiment are not provided, and the insertion portion 42 has a small diameter.

The treatment instrument channel 43 is adapted to be inserted with a treatment instrument for performing various treatments such as injecting a drug solution into a patient's body or excising and collecting a lesion site. In order to prevent filth and air inside the body from leaking to the outside due to changes in pressure, generally, the treatment tool insertion port 17
A sealing plug 46 is attached to the. on the other hand,
When the laser ablation treatment is performed by inserting the laser probe 29, a reflux plug 47 having an engaging portion having the same shape as the sealing plug 46 is mounted, and the sealing plug 46 is mounted on the reflux plug 47. It is designed to be sealed.

As shown in FIG. 5, the recirculation plug 47 has a cylindrical shape and has a lumen portion 48 inside, and has a shape similar to that of the sealing plug 46 at the lower part, which engages with the treatment tool insertion opening 17. A mating portion 49 is formed, and a sealing plug 4 having the same shape as the treatment instrument insertion port 17 is formed on the upper portion.
A plug engaging portion 50 that engages with 6 is formed. Sealing plug 4
6 is attached to the treatment instrument insertion port 17 via the reflux plug 47 so that the inside is communicated. Also, the reflux plug 4
The lumen portion 48 inside 7 is also opened laterally, and is provided with a pump connecting portion 51 that communicates with the lumen portion 48 and the treatment instrument channel 43.

The front water supply port body 45 is an air supply tube 31.
In addition, the pump connecting portion 51 of the reflux plug 47 is connected to the intake tube 32.
Are removably connected to the air-supply pump 34 and the intake pump 35 of the recirculation device 33. The reflux plug 47 may be formed integrally with the end portion of the intake tube 32. The connection may be reversed so that the intake tube 32 communicates with the front water supply channel 44 and the air supply tube 31 communicates with the treatment instrument channel 43.

When performing laser ablation treatment, the laser probe 29 is penetrated through the slit of the sealing plug 46, is inserted through the treatment instrument channel 21 via the sealing plug 46 and the reflux plug 47, and the probe tip portion is inserted into the insertion portion 42. Project from the tip of. Then, laser irradiation is performed from the laser probe 29 to the ablation treatment site to perform ablation.

The combustion smoke generated by the cauterization of the tissue is
Similar to the embodiment, by operating the reflux device 33 to perform reflux, combustion smoke is sucked and removed from the vicinity of the ablation treatment site. At this time, the combustion smoke is sucked from the treatment instrument channel 43 by the intake pump 35 through the reflux plug 47 and the intake tube 32. At the same time, air is sent from the front water supply channel 44 by the air supply pump 34 through the air supply tube 31 and the front water supply port body 45. Here, since the insufflation and the insufflation are performed in the same amount, the pressure inside the body cavity near the ablation treatment site is kept constant.

As described above, also in the second embodiment, as in the first embodiment, the smoke caused by laser cauterization can be sufficiently removed while the pressure inside the body cavity is kept constant, and the conduit for sucking the smoke, Can be easily washed by attaching and detaching a pump, etc. Also,
Since it is not necessary to provide a dedicated conduit for reflux in the endoscope, the diameter of the insertion portion can be reduced.

In this embodiment, as shown in FIG. 6, instead of connecting the intake tube 32 to the intake port 28, the intake tube 32 is inserted into the intake conduit as it is so as to protrude from the distal end of the endoscope. The suction may be performed at any position. Further, the opening of the intake pipe line 23 may not be provided on the same plane as the observation window but may be provided with a step so that the observation window is not smoked during suction. Further, by making the diameter of the air supply conduit larger than the diameter of the intake conduit to lower the pressure of the air supplied, it is possible to prevent the surrounding smoke from spreading due to the air supply. Further, the output switch of the laser device 30 and the switch of the reflux device 33 may be interlocked so that the reflux function operates only during the output of the laser.

Further, a laser probe 29 for cauterization
The air is sent to cool the probe. However, a part of the air sent may be exhausted from the side surface of the probe to remove the smoke on the front surface of the observation window. Further, the laser probe 29 may be provided with an intake mechanism in addition to the air supply function, and may be connected to a recirculation device so that smoke can be sucked.

By the way, in the electronic endoscope, as shown in FIG. 3, a signal from an image pickup device such as a CCD provided at the tip of the insertion portion is processed by a video processor to display an observation image on a monitor. It is also possible to provide a display unit including a small monitor and a processing circuit connectable to the operation unit. Most of the laryngoscopes used in otolaryngology are used on the bedside and do not need to be observed by a plurality of prescribers, so a large-sized device as in the past is not necessary. Therefore, by providing a small-sized display unit that can be observed on the hand side, operability can be improved and the device can be simplified.

FIG. 7 shows a first example of such an endoscope apparatus. The electronic endoscope 61 includes an elongated insertion portion 62 and an operation portion 63 that also serves as a grip portion that is continuously provided at the base end portion of the insertion portion 62.
It has and. A display unit 65 can be connected to the operation unit 63 via a connector unit 64, and the display unit 65 is connected and fixed to the operation unit 63 by the connector unit 64 so as to be integrally configured. .. Insertion part 6 of endoscope
The observation optical system 66 and this observation optical system 66
CC which is arranged at the image forming position for converting an optical image into an electric signal
A solid-state image sensor 67 including D and the like is provided. A light guide 68 that transmits illumination light is inserted into the insertion portion 62, and an illumination lens 69 that emits illumination light from the light guide 68 is provided at the tip end portion.

The display unit 65 is connected to the solid-state image pickup device 67 via a signal cable 70, and a signal processing unit 71 for converting a signal from the solid-state image pickup device 67 into an image signal, and an observation image connected to the signal processing unit 71. A small-sized monitor 72 configured by a liquid crystal monitor or the like for displaying, and a lamp 73 that emits illumination light. The signal processing unit 71, the monitor 72, and the lamp 73 are batteries that are attached to the display unit 65 and serve as a power supply unit. It is connected to 74 to receive power supply.

Illumination light from the lamp 73 is supplied to the connector section 6
The light passes through the light guide 68 through the illumination lens 69, and the illumination lens 69 irradiates the observation site from the tip of the endoscope. On the other hand, the image of the observation site is obtained by the observation optical system 66 by the solid-state image sensor 67.
An image is formed on the image, converted into an electric signal here, and sent to the signal processing unit 71 of the display unit 65 via the signal cable 70 and the connector unit 64. In the signal processing unit 71, the solid-state image sensor 6
The image pickup signal from 7 is converted into an image signal and output to the monitor 72, and an observation image is displayed on the monitor 72.

In this apparatus, the monitor 72 and the signal processing section 7
The signal processing unit 71 does not need to generate a standard video signal of NTSC or the like because only 1 and 1 are provided integrally, and only the minimum necessary signal processing for driving the monitor 72 may be performed. Therefore, the circuit configuration of the signal processing unit 71 can be simplified. Further, since it is not necessary to control a system including a plurality of devices as in the conventional case, the signal processing unit can be downsized and the display unit 65 integrated with the monitor 72 can be configured.

Therefore, according to this example, it is possible to observe on the hand side by the integrated simple system. In addition, since it is not necessary to prepare many devices to perform the examination, the examination can be easily performed even in a narrow place such as a patient room.

FIG. 8 shows a second example of the endoscope apparatus provided with a small display section. The endoscope 81 of the second example includes the insertion portion 62.
An image guide fiber 82 for transmitting an optical image is provided inside, and one end thereof is arranged at the image forming position of the observation optical system 66. Further, a solid-state image pickup device 84 is provided in the display unit 83 connected and fixed via the connector unit 64, and the optical image transmitted by the image guide fiber 82 is formed on the solid-state image pickup device 84, so It is designed to be converted into a signal.

Others are constructed in the same manner as in the first example, and in the case of an endoscope equipped with an image guide fiber, as in the first example, observation is made on the hand side by an integrated and simplified display section. can do.

FIG. 9 shows a third example of a small-sized display section connectable to the operation section. The display section 91 of the third example is provided with a movable section 92 that connects the display section 91 main body and the monitor 72, so that the monitor 72 can rotate in any direction with respect to the display section 91 main body. It is configured.

Other configurations, operations, and effects are similar to those of the first example. Further, in the third example, the operator easily observes by changing the direction of the monitor regardless of the position of the endoscope. Therefore, the operability at the time of inspection is improved.

FIG. 10 shows a fourth example of a small-sized display section connectable to the operation section. In the fourth example, the battery is not directly attached to the display unit 101, but the power supply unit 102 is separately provided and connected to the display unit 101. The power supply unit 102 is connected to a commercial power supply by an AC cord 103, and the signal processing unit 71 of the display unit 101,
Power is supplied to the monitor 72 and the lamp 73. The power supply unit 102 may be provided with a large battery separately from the display unit 101.
Alternatively, a commercial power source may be directly connected to a power source unit integrally provided with the power source 01.

As described above, this embodiment also has the same operation and effect as those of the first embodiment. Further, by making the power supply unit separate, it is possible to further reduce the size and weight.

[0046]

As described above, according to the present invention, smoke produced by laser cauterization can be reliably and sufficiently removed while the pressure inside the body cavity is kept constant, and reliable laser cauterization can be performed. There is an effect that it is possible to easily clean the pipeline, the pump, etc. that perform the suction, and it is possible to reliably remove the stains on the pipeline and the like due to the suction of smoke.

[Brief description of drawings]

1 to 3 relate to a first embodiment of the present invention,
FIG. 1 is an explanatory diagram showing a configuration of a main part of the endoscope apparatus.

FIG. 2 is a front view of the distal end of the endoscope insertion portion as viewed from the direction A in FIG.

FIG. 3 is an explanatory diagram showing a configuration of the entire endoscope apparatus.

4 and 5 relate to a second embodiment of the present invention, and FIG. 4 is an explanatory diagram showing a configuration of a main part of the endoscope apparatus.

FIG. 5 is a cross-sectional view showing a configuration of a reflux plug provided at a treatment instrument insertion port of an endoscope operation section.

FIG. 6 is an explanatory diagram showing an example of an endoscope device that inserts an intake tube directly into an intake conduit to perform suction.

FIG. 7 is a structural explanatory view showing a first example of an endoscope apparatus provided with a small display unit connectable to an operation unit.

FIG. 8 is a structural explanatory view showing a second example of an endoscope apparatus provided with a small display unit connectable to an operation unit.

FIG. 9 is a structural explanatory view showing a third example of a small-sized display unit connectable to an operation unit.

FIG. 10 is a structural explanatory view showing a fourth example of a small-sized display unit connectable to an operation unit.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Endoscope 2 ... Operation part 3 ... Insertion part 21 ... Treatment instrument channel 22 ... Air supply pipe line 23 ... Intake pipe line 27 ... Air supply port 28 ... Intake port 29 ... Laser probe 30 ... Laser device 31 ... Air supply tube 32 ... Intake tube 33 ... Reflux device 34 ... Air supply pump 35 ... Intake pump

Claims (1)

[Claims] 1. An endoscope apparatus comprising an endoscope capable of inserting a probe for cautery treatment into an elongated insertion part, wherein the endoscope is inserted into the insertion part and one end thereof is inserted into the insertion part. Has a conduit opening at the tip of the part and the other end opening at the operating part on the near side, and having an intake means and an air supply means for supplying the same amount of air as the intake amount of the intake means, An intake passage communicating with the intake means and an air supply passage communicating with the air supply means are detachably attached to or detachable from the conduit of the endoscope, and a return means is provided for performing a return flow. A characteristic endoscopic device.