JPH0739510A - Endoscope - Google Patents

Abstract

PURPOSE:To make easily obtain a field of view to guide a treatment tool to an objective position by providing a plurality of observatory parts on the tip component of an endoscope and a field switching means to switch a plurality of observatory fields. CONSTITUTION:A tip opening 11 of a channel for inserting forceps set in an inserting part, two pairs of objective lenses 12 and 13 and two pairs of lighting lenses 14 are set on the tip face 8 of an endoscope tip component 8a. An angle alphamade by two straight lines tieing the center O of the tip opening 11 of the channel for forceps inserting and the respective centers of the objective lenses 12 and 13 is set at least not less than 90 deg. and as close as possible to 180 deg.. An eyepiece lens 4a, a field switching ring 9 to switch the field of view and an optical fiber bundle holder 44 are set on an eyepiece 4, and a prism 41 is set on the field switching ring. Optical fiber bundles 42 and 43 are positioned on the optical fiber bundle holder 44 to make the distance from the center of the field switching ring 9 to optical fiber bundles 42 and 43 equal.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscope for observing the inside of a body cavity of a living body and inserting a treatment tool such as forceps into the body cavity for medical treatment.

[0002]

2. Description of the Related Art Generally, for example, JP-A-3-26873.
As shown in Japanese Patent Publication No. 6, an illumination optical system for observing the inside of the body cavity, an observation optical system, and a tip opening portion of a forceps insertion channel are provided at the tip portion of the insertion portion of the endoscope inserted into the body cavity. Has been. Further, a proximal operation portion is connected to the proximal end portion of the insertion portion. The operation section is provided with a forceps insertion section, an eyepiece section and the like. Here, a forceps insertion port is formed in the forceps insertion portion. Furthermore, a forceps insertion channel, optical fiber bundles for illumination and observation, and the like are arranged in the insertion portion of the endoscope. The proximal end portion of the forceps insertion channel is connected to the forceps insertion port of the operation unit. The eyepiece is optically connected to the objective lens of the observation optical system via the observation optical fiber bundle.

Further, when the endoscope is used, a treatment tool is inserted through a forceps insertion port. This treatment tool passes through the forceps insertion channel and is projected to the outside of the endoscope from the opening of the distal end of this channel. Then, while observing the observation image that has reached the eyepiece section from the observation optical system via the observation optical fiber bundle, the treatment tool can be used to collect cells and foreign matter in the body cavity.

In the above-mentioned publication, the surface of the channel provided at the tip of the insertion portion of the endoscope is tilted in the direction in which it is raised with respect to the surface of the objective lens. The forceps and the like are made to project obliquely from the distal end opening portion of the channel with respect to the long axis of the insertion portion, so that the forceps and the like can be easily observed from the objective lens.

[0005]

Generally, the positional relationship between the observation optical system installed at the distal end of the insertion portion of the endoscope and the distal end opening portion of the forceps insertion channel is determined in consideration of each function. It is determined by the layout of the tip of the endoscope. Therefore, the field of view of the endoscope viewed through the observation optical system is fixed, and the position of the treatment tool displayed in this field of view is also fixed under the currently observed field of view. It may be difficult to accurately guide the treatment tool to a target site in a blind spot in the field of view of the endoscope, such as a shadowed part. The present invention has been made in view of the above problems, and an object of the present invention is to provide an endoscope capable of ensuring a visual field in which a treatment tool can be easily guided to a target site.

[0006]

In an endoscope having at least one forceps insertion channel, a plurality of observation sections are provided in a distal end forming section at the tip of an insertion section to be inserted into a body cavity. Switch parts to use
A visual field switching means for changing the observation visual field is provided.

[0007]

[Function] By selectively selectively switching the visual field switching means, the target site can be observed from different angles,
The position of the treatment tool displayed in the visual field is changed.

[0008]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A first embodiment of the present invention is shown in FIGS.
A description will be given based on (b). FIG. 2 is an endoscope 1 according to this embodiment.
It shows an overall schematic configuration. The endoscope 1 is provided with an insertion portion 3 to be inserted into a body cavity and an operation portion 2 on the proximal side connected to a proximal end portion of the insertion portion 3.

An eyepiece 4 is provided at the base end of the operation portion 2, and a suction control device 6 and an angle operation lever 5 are provided in front of the eyepiece 4. Further, the operation unit 2
A forceps insertion portion 10 is provided on the side of the.

Further, a distal end forming portion 8 is connected to the distal end side of the insertion portion 3 via a curved portion. The bending portion is bent as the angle operation lever 5 of the operation portion 2 is operated.

FIG. 1 shows a layout of the tip forming portion 8. The insertion portion 3 is attached to the tip surface 8a of the tip forming portion 8.
Tip opening portion 1 of the forceps insertion channel disposed inside
One or two sets of objective lenses (observation sections) 12, 13 and two sets of illumination lenses 14 are provided.

The positional relationship between the tip opening 11 of the forceps insertion channel and the objective lenses 12 and 13 is as follows: the center point O of the tip opening 11 of the forceps insertion channel and the center of each of the objective lenses 12 and 13. The angle α between the two straight lines connecting between and is at least 90 °
It is set to be close to 80 °.

The tip opening 11 of the forceps insertion channel is connected to the forceps insertion port 10a of the forceps insertion portion 10 shown in FIG. 3A via the forceps insertion channel. A bifurcated bifurcation is provided in the middle of the forceps insertion channel. One of the branch portions is connected to the forceps insertion port 10a of the forceps insertion portion 10, and the other is connected to the suction control device 6. Here, the suction control device 6
Suction can be performed via a forceps insertion channel provided inside the insertion portion 3.

3 (a) and 3 (b) show the forceps insertion portion 10 of the endoscope. A forceps plug 7 is detachably attached to the forceps insertion portion 10. The forceps plug 7 attached to the forceps insertion portion 10 allows the insertion of the treatment tool and the delivery of anesthesia solution or the like. Here, the forceps plug 7 has a second portion that is pressed against the tip surface of the forceps insertion portion 10.
The valve member 18 and the disc-shaped first valve member 17 provided on the upper part of the second valve member 18 are housed by a substantially cylindrical cover member 20. Further, closing films 16 and 19 are provided at the central portion of the first valve member 17 and the lower end of the second valve member 18, respectively. These blocking films 16 and 19 are for maintaining airtightness when a forceps or the like is inserted. An upper slit 16a and a lower slit 19a are formed in the center of each of the blocking films 16 and 19 for inserting forceps or the like. further,
The pin 15 is removably inserted into the slits 16a and 19a of the forceps plug 7.

The pin 15 serves to prevent the slits from sticking to each other, and has a long flat plate-shaped main body portion 15b and a circular flat plate portion 1 as a stopper.
5a, and the base end portion of the main body portion 15b is connected to the plate portion 15a. Then, the pin 15 is attached to the forceps plug 7 with the main body portion 15b being inserted into the upper slit 16a and the lower slit 19a. In addition,
The forceps plug 7 is attached to the forceps insertion portion 10 in this state.

Therefore, by forming the pin 15 as described above, the main body portion 15b of the pin 15 can be made into the lower slit 1.
The tip of the body portion 15b of the pin 15 is not pinched between the lower end of the second valve member 18 and the upper end of the forceps insertion portion 10 because it does not swing significantly inside 9a. Therefore,
After the forceps plug 7 is attached to the forceps insertion portion 10, the pin 15 can be freely removed at any time.

FIGS. 4A to 6 show, as an example of forceps inserted from the forceps plug 7, a grasping forceps 21 through which a treatment tool can be inserted.
It shows the configuration of. Grasping forceps 2 through which a treatment tool can be inserted
As shown in FIG. 4 (a), the reference numeral 1 comprises a flexible sheath 23 made of, for example, a coiled body such as a closely wound coil, a tip member 24 attached to the tip of the flexible sheath 23, and grip portions 25a, 25b. The distal treatment section R, the auxiliary treatment instrument insertion section 26 connected to the proximal end of the flexible sheath 23, and the operation section 27 connected to the proximal end of the auxiliary treatment instrument insertion section 26. .

The center of the tip member 24 is shown in FIG.
As shown in (b), a central opening 29 is provided, and wire holes 30 are provided at symmetrical positions with the central opening 29 interposed therebetween.
a and 30b are provided. And the central opening 29
Between the wire holes 30a and 30b and the pair of support plates 28a
b is provided. Here, on the outside of the support plates 28a and 28b, as shown in FIG.
25b is rotatably attached by pins 31a and 31b. Then, at the base end portions of the grip portions 25a and 25b,
As shown in FIG. 5, operation wires 32a and 32b are attached respectively. The operation wires 32a and 32b extend into the flexible sheath 23 through the wire holes 30a and 30b and are inserted into the flexible sheath 23.
It is fixed at the tip of. A treatment instrument insertion tube 34, which is inserted into the operation tube 33, is connected to the central opening 29.

Here, the base end of the operation tube 33 is fixed to a slider 35 provided on the operation portion 27. Then, as shown in FIG. 6, a side hole 33 is provided near the proximal end of the operation tube 33.
a is provided, the treatment instrument insertion tube 34 that has been inserted through the operation tube 33 from the side hole 33a comes off, and the mouth of the treatment instrument insertion port body 36 provided on the side of the auxiliary treatment instrument insertion portion 26 is provided. It is connected to the portion 36a. Here, the side hole 33a is
It is formed in a size that does not interfere with the treatment instrument insertion tube 34 when the operation tube 33 is slid.

From the treatment instrument insertion port 36, an auxiliary treatment instrument such as the injection needle 22 shown in FIG. 4A is inserted. The injection needle 22 is composed of a needle 37 connected to the distal end of the flexible tube 38 and a liquid delivery mouthpiece 39 connected to the proximal end of the flexible tube 38. Here, the front end of the liquid delivery mouthpiece 39 is the treatment instrument insertion port body 3.
6, and the needle 37 projects outward from the central opening 29 of the tip member 24 as shown in FIG.

When using the treatment instrument insertable grasping forceps 21, first, the grasping forceps 21 is inserted into the body cavity from the forceps plug 7 through the forceps inserting channel in the endoscope,
The tip of the grasping forceps 21 is projected from the tip opening 11 of the forceps insertion channel, and is opposed to the esophageal varix 40 shown in FIGS. 8A and 8B, for example.

Next, the slider 35 of the operating portion 27 is moved forward. Thereby, the operation wire 32 is passed through the operation tube 33.
a, 32b move forward, and the gripping portions 25a, 25b move to the pin 3
The grips 25a and 25b are opened by rotating the support plates 28a and 28b around the la and 31b. Then, the grip 2
By positioning the esophageal varix 40 between the 5a and 25b and pulling the slider 35 toward the proximal side, the grips 25a and 25
b is closed and the esophageal varix 40 is gripped as shown in FIG.

Then, as shown in FIG. 7, the injection needle 22 is inserted through the mouth portion 36a, and the front end of the liquid supply mouthpiece 39 is grasped by the forceps 2.
It is fitted to the mouth portion 36a of the insertion mouth body 36 of No. 1. Then,
The needle 37 projects from the central opening 29 of the tip member 24. Then, as shown in FIG. 8B, the needle 37 is pierced into the esophageal varix 40, and a drug such as a curing agent is injected with a syringe.

Therefore, when the injection needle 22 is punctured, the esophageal varices 40 are grasped by the grasping forceps 21, so that the puncture portion does not move and the injection needle 22 is reliably esophageal varices 4.
Can be punctured to zero.

If a biopsy forceps or a high-frequency snare is used in addition to the injection needle 22, a flat tissue can be grasped by the grasping portion 25 to be raised and the tissue can be collected, so that a larger tissue specimen can be obtained. .

FIG. 9A shows the eyepiece section 4. The eyepiece 4 has an eyepiece 4a and the eyepiece 4
a visual field switching ring 9 for switching the visual field of a,
An optical fiber bundle holder 44 is provided. The field-of-view switching ring 9 is provided with a prism 41.

Further, the base end portions of the two sets of observation optical fiber bundles 42 and 43 are fixed to the optical fiber bundle holder 44. Then, the optical fiber bundles 42 and 43 are arranged in the optical fiber bundle holder 44 so as to be at the same distance from the center of the visual field switching ring 9, as shown in FIG. 9B. The tips of the optical fiber bundles 42 and 43 are optically connected to the objective lenses 12 and 13 of the tip forming section 8 to transmit the image from the observation optical system of the tip forming section 8 of the insertion section 3. Note that three or more objective lenses may be provided.

The field switching ring 9 is rotatably connected to the optical fiber bundle holder 44. Along with the turning operation of the field-of-view switching ring 9, the prism 41 is opposed to either one of the observation optical fiber bundles 42 and 43, and the light emitted from the observation optical fiber bundle 42 or 43 passes through the prism 41. Eyepiece 4
It is led to a.

Next, the operation of the first embodiment will be described.
First, as shown in FIG. 10, the treatment tool 45 is inserted through the slit of the forceps plug 7, passed through the forceps insertion portion 10, and further,
After passing through the forceps insertion channel, the treatment tool tip 46 of the treatment tool 45 is projected into the body cavity through the tip opening 11 of the forceps insertion channel.

Then, with the naked eye from the eyepiece section 4 or with a CCD camera installed in the eyepiece section 4, one optical fiber bundle 4
Objective lens 12 (or 13) through 2 (or 43)
Observe the inside of the body cavity more. As shown in FIG.
When 5 is protruding from the tip opening 11 of the forceps insertion channel, the treatment instrument 45 outside the forceps plug 7 is operated while observing the treatment instrument tip 46 of the treatment instrument 45 from the eyepiece 4. The distal end portion 46 of the treatment tool is guided to the target site 47 in the body cavity projected in the observation visual field of the eyepiece 4 shown in FIGS.

At this time, an example of the visual field observed from one objective lens 12 is shown in FIG. 11A, and an example of the visual field observed from the other objective lens 13 is shown in FIG. 11B. ). As shown in FIG. 11A, when the inside of the body cavity is observed using the objective lens 12, the target site 4
7 enters the blind spot of the treatment instrument tip 46, and it is difficult to guide the treatment instrument tip 46 to the target site 47. However, when the field-of-view switching ring 9 of the eyepiece 4 is rotated to observe the inside of the body cavity using the objective lens 13 through the optical fiber bundle 43, as shown in FIG. Is the target site 47 without being disturbed by the treatment tool tip 46.
Can be observed and treated.

According to the first embodiment, since the visual field switching ring 9 of the eyepiece section 4 is provided in the operation section 2 on the near side of the endoscope 1, the outside of the distal end forming section 8 of the insertion section 3 is provided. The diameter can be made relatively small. Therefore, it is possible to prevent the insertability of the insertion portion 3 into the body cavity from being deteriorated. Further, a plurality of objective lenses 12 and 13 are provided in the distal end forming portion 8 of the insertion portion 3 inserted into the body cavity, and the observation visual field is changed by operating the visual field switching ring 9 to switch the plurality of objective lenses 12 and 13. By doing so, it is possible to select a visual field in which the target portion 47 is easily visible with respect to the treatment instrument distal end portion 46, and the aiming property of the treatment instrument distal end portion 46 to the target portion 47 is improved.

Next, the second embodiment will be described with reference to FIGS.
A description will be given based on (a) and (b). The second embodiment is a modification of the layout of the tip forming section 8, and FIG. 12 shows the layout of the tip forming section 8. The distal end surface 8a of the distal end forming portion 8 is provided with the distal end opening 11 of the forceps insertion channel, two sets of objective lenses 48 and 49, and two sets of illumination lenses 14.

Here, regarding the positional relationship between the tip opening 11 of the forceps insertion channel and the objective lenses 12 and 13, the tip opening 11 of the forceps insertion channel is provided at the center, and the objective lenses 22 and 23 are the channels. They are arranged at symmetrical positions with the opening 11 in between.

Next, the operation of the second embodiment will be described.
First, as in the case of the first embodiment, the treatment tool 45 is inserted into the endoscope 1 and the distal end opening portion 1 of the forceps insertion channel 1 is inserted.
The distal end portion 46 of the treatment tool is projected into the body cavity from 1.

At this time, an example of the visual field observed from one objective lens 48 is shown in FIG. 13A, and an example of the visual field observed from the other objective lens 49 is shown in FIG. 13B. ). As in the case of the first embodiment, when a blind spot occurs in the visual field from the objective lens 48, it is easy to guide the treatment instrument tip 46 to the target site 47 in the observation visual field of the eyepiece 4. Then, by rotating the visual field switching ring 9 of the eyepiece unit 4, a visual field without a blind spot from the objective lens 49 as shown in FIG. 13B can be obtained.

According to the second embodiment, by changing the dead angle of the treatment instrument tip 46 in the visual field of the eyepiece 4 by 180 °, the direction of the treatment instrument tip 46 toward the target site 47 is changed. It changes sensuously, and the distal end portion 46 of the treatment tool is the target portion 4
Since it is possible to select a field of view that makes it easy to treat 7, it is possible to further improve the aimability of the treatment tool distal end portion 46 to the target portion 47.

Further, FIGS. 14A and 14B show the endoscope 1
7 shows a modification of the pin 51 attached to the forceps plug 7. The pin 51 is composed of a circular flat plate portion 51a to which the base end of a cylindrical portion 51b is connected, and a flat plate portion 51c provided at the tip of the cylindrical portion 51b. And
It is set so that the upper slit 16a is in contact with the cylindrical portion 51b and the lower slit 19a is in contact with the flat plate portion 51c. Pin 51
The column portion 51b and the flat plate portion 51c are inserted through the upper slit 16a and the lower slit 19a, and the entire pin 51 is rotated and attached to the forceps plug 7 so that the flat surface of the flat plate portion 51c is aligned with the direction of the lower slit 19a.

Therefore, by configuring the pin 51 as described above, even when the orientation of the upper slit 16a and the lower slit 19a is different from that of the pin 15 of the first embodiment, the flat surface of the flat plate portion 51c becomes The lower slit 19a is aligned with the upper slit 16a, and the upper slit 16a is aligned with the pin 51. Therefore, the pin 51 can be left with the pin 51 pierced without damaging each slit. It should be noted that the present invention is not limited to the above-described embodiments, and it goes without saying that various modifications can be made without departing from the scope of the present invention.

[0040]

EFFECTS OF THE INVENTION Since a plurality of observation parts are provided at the tip forming portion at the tip of the insertion part to be inserted into the body cavity, and a visual field switching means for switching the observation visual field by switching the plurality of observation parts is provided. The field of view that allows the target site to be easily seen with respect to the treatment tool can be selected, and the sniperability of the treatment tool to the target site is improved.

[Brief description of drawings]

FIG. 1 is a front view of a tip forming portion of an endoscope according to a first embodiment.

FIG. 2 is a perspective view showing an external appearance of an endoscope.

3A is a vertical cross-sectional view showing a forceps insertion portion, and FIG. 3B is a cross-sectional view taken along the line AA of FIG.

FIG. 4A is a schematic configuration diagram of a grasping forceps through which a treatment tool can be inserted and an injection needle that is inserted into the forceps, and FIG. 4B is a line AA of FIG.
A line sectional view, (c) is a BB line sectional view of (a).

FIG. 5 is a perspective view of a treatment section of a grasping forceps that can be inserted through a treatment tool.

FIG. 6 is a vertical cross-sectional view of an auxiliary treatment instrument insertion portion of a grasping forceps capable of inserting a treatment instrument.

FIG. 7 is a side view showing a state in which an injection needle is inserted into a grasping forceps that can be inserted through a treatment tool.

FIG. 8A is a side view showing a state where the treatment instrument insertable grasping forceps is grasping an esophageal varix, and FIG. 8B is a diagram showing a case where a drug is injected from an injection needle inserted in the treatment instrument insertable grasping forceps. FIG.

9A is a vertical cross-sectional view near the eyepiece, and FIG. 9B is a cross-sectional view taken along the line AA of FIG. 9A.

FIG. 10 is a perspective view showing a state in which a treatment tool is inserted through the endoscope.

11A is a plan view showing an observation visual field of a first objective lens, and FIG. 11B is a plan view showing an observation visual field of a second objective lens.

FIG. 12 is a front view of the distal end configuration portion of the endoscope of the second embodiment.

13A is a plan view showing an observation visual field of a first objective lens, and FIG. 13B is a plan view showing an observation visual field of a second objective lens.

FIG. 14A is a vertical cross-sectional view of a state in which a pin is attached to a forceps plug, and FIG. 14B is a cross-sectional view taken along the line BB of FIG. 14A.

[Explanation of symbols]

8 ... Tip configuration part, 9 ... Visual field switching ring (visual field switching means), 12, 13, 48, 49 ... Objective lens (observation part).

 ─────────────────────────────────────────────────── ─── Continuation of the front page (72) Inventor Takeshi Takigawa 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Inventor Yoshio Tashiro 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Yosuke Yoshimoto 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Tsutomu Okada 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Industry Co., Ltd.

Claims (1)

[Claims] 1. An endoscope having at least one forceps insertion channel, wherein a plurality of observation parts are provided at a distal end constituting portion of a distal end of an insertion part to be inserted into a body cavity, and the plurality of observation parts are switched and used. Then, the endoscope is provided with visual field switching means for changing the observation visual field.