JPS59181122A - Advance and retraction guide apparatus of endoscope - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

DETAILED DESCRIPTION OF THE INVENTION [Technical Field of the Invention] The present invention relates to an advancement/retraction guidance device for an endoscope or the like that can be inserted smoothly into a curved body cavity such as the large intestine.

[Technical background of the invention and its problems]

In recent years, endoscopes have been widely used for medical and industrial purposes.

Some of these endoscopes have a hard insertion section and are inserted into the abdominal cavity while being guided through a puncture such as a trocar, and others have a soft insertion section that does not require the above puncture and are inserted into the oral cavity or anus. There are soft types that can be inserted into the target site via a curved intrabody cavity route.

The operation of inserting the above-mentioned flexible endoscope deep into the body cavity through a curved path such as the S-shaped part, which occurs when inserting the flexible endoscope from the anus into the large intestine, requires a highly skilled technique. If the surgeon was not skilled in this area, the patient would be in great pain.

For this reason, various conventional examples have been disclosed in which a means for propelling the insertion section is provided on the distal end side of the insertion section of the endoscope, thereby making it possible to insert the endoscope deep into the insertion section.

For example, as disclosed in Japanese Unexamined Patent Publication No. 54-160083, a screw-shaped propulsion ring is attached to the distal end of the insertion section, and the rotation of the propulsion ring is remotely controlled from the hand side. There is a conventional example in which the insertion sections are propelled together by a screwing motion. In this conventional example, when screwing in,
There is a risk of twisting and damaging the intestinal wall, etc.

For this reason, the conventional example disclosed in Japanese Patent Application Laid-Open No. 55-45426 has a structure in which the motors are propelled by rotating in opposite directions in order to eliminate the drawbacks of the above-mentioned conventional example. However, even in this conventional example, rotation in opposite directions creates parts where the folds of the intestinal wall are separated, and if this condition progresses further, the propulsion function decreases and there is a risk of damaging the intestinal wall. have

In addition, a balloon for propulsion is attached to the distal end of the insertion tube,
By inflating and deflating the balloon,
There are conventional examples to promote this. This conventional example has the disadvantage that it takes time to insert it to the required depth because the amount of movement propelled by expansion and contraction for propulsion cannot be made very large.

In addition, in these conventional examples, the outer diameter of the insertion portion is increased, which causes great pain to the patient during insertion.

In addition, without attaching anything to the endoscope insertion section, the endoscope insertion section is given a simple back-and-forth movement or a simple rotational movement outside the insertion port, and the endoscope is inserted into the insertion section. There is, but
It was difficult to penetrate deeply into the body using simple operations such as those described above.

[Purpose of the invention]

The present invention has been made in view of the above-mentioned points, and allows for easy insertion and withdrawal by automatically performing insertion and withdrawal operations similar to those performed by the most skilled surgeon. At the same time, it is an object of the present invention to provide an advancement/retraction guiding device MfC for an endoscope, etc., which causes less pain to the patient.

[Summary of the invention]

The present invention provides a water body that holds a tubular section such as an insertion section of an endoscope with at least one of a drive system that allows the insertion section to move back and forth and a drive system that provides rotational motion. In addition, a control device section for controlling the drive system is provided.

[Embodiments of the invention]

Hereinafter, the present invention will be specifically explained with reference to the drawings.

1 to 6 relate to an embodiment of the present invention, FIG. 1 shows the embodiment in use, FIG. 2 shows the structure of the embodiment in cross section, and FIG. 3 shows the embodiment in use. The front view of FIG. 2 is partially cut away, FIG. 4 shows the configuration of the control device section of one embodiment, and FIG. 5 shows the temporal change in one example in which the longitudinal motion roller is driven. FIG. 6 shows temporal changes in the rotation angle in one example in which the rotational roller is driven.

As shown in FIG. 1, an advancement/retraction guiding device (hereinafter simply referred to as an advancing/retracting (guiding) device) 1 for an endoscope or the like according to an embodiment has a flexible (soft) insertion portion 3 of an endoscope 2. The main body part 4 of the advancing/retreating guidance device to be held, and controlling the main body part 4 (of the advancing/retracting guiding device), as well as 1. It is comprised of a control device section 5 equipped with a drive power source.

The endoscope 2 has an illumination optical system that emits illumination light supplied from an external light source 6 from the distal end side of the insertion section through a light guide cable 7 and a light guide inserted through the flexible insertion section 3. The system and the illuminated object are imaged by an objective lens and transmitted to the operation unit 8 side by a flexible image guide inserted through the insertion section 3, and observation that can be observed from the rear of the eyepiece section 9. An optical system is formed.

On the other hand, the main body part 4 attached to the outer periphery of the insertion part 3 is
The structure is shown enlarged in FIGS. 2 and 3.

That is, the first hollow annular part is slightly larger than the outer diameter of the insertion part 3.
Concave portions are formed in two stages in the axial direction at, for example, four locations on the inner periphery of the bearing 12, and each of these concave portions is provided with the longitudinally moving rollers 13, 13, . ... 13 is housed in the insertion portion 3 so as to be freely rotatable in the axial direction.

First, the second bearing 1 is loosely fitted to the outer periphery of the first bearing 12.
4, four parts are formed in two stages at four places, for example, and a rotary roller 15 is installed in each of these recesses.
,15. -..., 15 accommodate the first bearing 12 so as to be rotatable (rotatable) around its axial direction (indicated by arrow A).

The above-mentioned longitudinal movement rollers 13, 13. . . , 13 is arranged so that the rotation of the roller 13 can detect the amount of movement of the insertion section 3 that moves forward or backward in contact with the roller 13, as shown in FIG. As a motion detecting means, a shaft 17A of a variable resistor (potentiometer) 17 is attached to the rotating shaft of the roller 13, and the main body of the variable resistor 17 is fixed in a recess formed in the first bearing 12.

Further, the rollers 13, 13. ..., 13 is an electric signal whose rotating shaft is attached to the rotating shaft 18A of the longitudinal drive motor 18 and is supplied via the cable 19,
By rotating the motor 18 in the forward or reverse direction, the roller lj attached to the motor 18 is rotated, and the insertion section 3 is set to be able to be moved forward or backward.

Similarly, the rotary rollers 15, 15. ..., one in 15 is the first bearing 12 (or the insertion part 3 that rotates together with the first bearing 12) that comes into contact with the roller 15 as the roller 15 rotates as shown in FIG. The shaft 21A of the variable resistor 21 is attached to the rotating shaft of the roller 15 as a rotation detecting means so that the rotation angle of the variable resistor 21 can be detected.

Further, the roller 15.15. . . . , 15 has a rotating shaft 22A of a rotary motion drive motor 22 attached to its rotating shaft, and rotates the motor 22 in the forward or reverse direction with an electric signal supplied via the cable 23. The roller 15 connected to the motor 22 is rotated by the rotation of the motor 22 (of the rotation shaft 22A), and the roller 15 connected to the motor 22 is rotated to rotate the insertion portion 3 together with the first bearing 12 relative to the second bearing 14.
is now rotated.

Incidentally, each rotating shaft 18A of the motors 18 and 22.

The rollers 13 and 15 attached to the roller 22A can rotate smoothly when the motors 18 and 22 are not driven. In addition, each of the P' resistors 17 and 21 for detecting longitudinal motion and rotational motion is connected to the control device section 5 via a signal line (path shown in the figure) in the signal cable 24, as shown in FIG. Each axis 17A.

By measuring the resistance values that vary depending on the rotation of the roller 21A, the amount of rotation of each roller 13, 15, the amount of movement (rotation angle) of the back and forth movement and rotation of the pick insertion portion, and their The position can be detected.

By the way, each of the above-mentioned motors 18 and 22 is a motor that can be rotated by an arbitrary angle in the forward direction and in the reverse direction by an electric signal supplied from the control device section 5 through the cables 19 and 23, respectively.

The control device section 5 is configured as shown in FIG. 4, for example. That is, a constant voltage source 31 housed in the control device section 5 supplies a constant voltage to both ends of each variable resistor 17.21 via a signal line (not shown), and each shaft 17A, 2
Variable resistance terminals whose resistance is varied by rotation of 1 A are respectively connected to input terminals of voltage controlled oscillators (voltage frequency converters) 32 and 33.

The voltage controlled oscillators (VCO) 32 and 33 have an output signal whose oscillation frequency changes according to the potential impressed at the input end, and the outputs of the oscillators 32 and 33 are connected to amplifiers, respectively. 34.35 and each interlocking switch 36
．． 37 and are simultaneously recorded by recording and reproducing heads 38 and 39 on a tape 40 moving at a constant speed.

Also, during playback, the switched interlocking switch 36.
37, each regenerated electrical signal being sufficiently amplified by an amplifier 41.42 and said amplifier 34.
Passed through 35 (actually driven state was detected)
A phase comparator 43 that inputs an electrical signal, softens the ratio, and outputs the signal.
．． 44, respectively. The output of each phase comparator 43, 44 controls the rotation of each motor 18, 22 via a rotor filter 45, 46, respectively.

That is, each motor 18, 22 has a phase comparator 43.
If the output of 44 does not match the regenerated signal and the electrical signal in the actually driven state, a signal corresponding to the direction of the deviation is output, and this output is passed through low-pass filters 45 and 46. to ensure that each motor 18.22 has little misalignment.
control so that the In other words, the motors 18 and 22 are driven so as to quickly match the positions of the variable resistors 17 and 21 corresponding to the reproduced signals, and when they match, the state is maintained. In other words, each motor 18, 22 is controlled so as to reproduce the same state as during recording.

The operation of one embodiment configured in this manner will be described below.

When inserting using the above-mentioned first embodiment, after setting as shown in FIG. 1, each motor 18, 22 is not operated and the insertion operation is actually performed by a surgeon who is extremely skilled in the insertion operation. In this case, the forward/backward movement and rotational movement performed by the operator are separately detected by the variable resistors 17 and 21, sufficiently amplified through the VCOs 32 and 33, and recorded on the tape 40.

Therefore, once the insertion operation is recorded, the signal recorded on the tape 40 can be reproduced, and each position of each variable resistor 17, 21 corresponding to the reproduced signal and the actual position can be determined. If each position is different, each phase comparator 43.4
4 and filters 45 and 46 become positive or negative, and each motor 1B, 22 is quickly driven to match by this positive or negative output. Each knob motor 18,
22 allows the insertion operation to be performed by a skilled surgeon by inserting the insertion portion 3 while moving it back and forth and rotating it so as to match the recorded signal. The above tape 40
If it is made into a cassette tape, it can be used interchangeably depending on the insertion site.

The insertion operation performed by the above-mentioned skilled surgeon is, for example, as shown in FIGS. 5 and 6.

In other words, the longitudinal motion rollers 13, 13. ..., 13 is...
In addition to the insertion operation, for example, as shown in FIG.
The rollers 15, 15, . . . are vibrated back and forth with an amplitude B of [hu: ] to 20 Ctan] and a period T of 0.1 [sec:]% to 2 [sec].
, 15 is a swing if! of 1 [degree] to 10 [degree] in the period T as shown in FIG. It is performed while rotating and vibrating at C. By applying such fine vibrations,
Friction between the insertion section 3 and the body cavity wall can be reduced, and the endoscope insertion section 3 can be inserted smoothly.

In addition, since the angle at which the rotation is made in the above description is generally not very large, the variable resistor 17 attached to the first bearing 12 and the cable 19 connected to the motor 18 which are rotated together with the insertion section 3 are Although it is sufficient to provide a certain amount of leeway, it is also possible to use a brush or the like to transmit the signal, similar to the structure of a normal motor.

Note that if the variable resistors 17 and 21 mentioned above are of helical rotation type (multi-rotation type), the number of rotations can also be detected. Furthermore, even if the variable resistor is of a one-turn type and has a structure that returns to the original angle (position) after one rotation, means for detecting the rotation angle of the variable resistor 17 and 21 should be provided as necessary. You can also do it.

This can be simultaneously recorded on different parts of the tape 40, or it can be multiplexed as in a video tape recorder (the signals for the longitudinal motion and rotational motion can also be multiplexed in the same way. ).

Incidentally, the tape 40 may be a cassette tape or the like, or a continuous tape may be used if the recording signal is repetitive. Furthermore, if the repetition period is short, a semiconductor recording device can also be used.

In the above-mentioned embodiment, the configuration is such that it is converted into a frequency and recorded, but it is also possible to record it on the tape 40 or a magnetic disk as a digital amount using an analog-to-digital (AD) e-converter. A semiconductor device can be used if the process is repeated for a short period of time. In the case of the above-mentioned semiconductor devices such as RAM or ROM, a counter or the like is used to designate and read an address when outputting a recorded signal. Further, it is also possible to use a FloraBetif, which is widely used as a recording (reproducing) device for microcomputers and the like.

Further, the control device section 5 is not limited to the one described above, and can also be formed using or combining other known means.

Incidentally, a phase comparator 43.4 is used as a means for controlling each motor 18, 22 to a state corresponding to the reproduced signal.
4, a counter and a digital comparator can also be used. In other words, each signal is counted within a (short) fixed period of time, the outputs are compared in magnitude by each digital comparator, and the motors 18 and 22 are controlled based on the comparison output. When using this digital comparator, it is also possible to configure the output of each variable resistor 17, 21 to be AD converted and recorded and input to the digital comparator to control each motor 18° 22 as described above. .

Note that the control device section 5 houses a function generator, generates signals of various waveforms by the function generator, records the signals in the Qi 140, etc., and reproduces the signals to control the motor. 18.22.

Incidentally, the motor 18 for driving the longitudinal movement or the motor 22 for driving the rotary movement at the above-mentioned pressure can be set to have an appropriate torque (less than) so as not to cause pain to the patient's sister by force during the insertion operation. . This can also be applied to the rollers 13 and 15 side.

In other words, it is possible to prevent rotation when the load exceeds a certain value. In these cases, the phase difference or frequency difference input to the phase comparator 43 or 44 is affected, so when the difference exceeds a certain value,
Alternatively, a display may be used to inform the operator when the difference is greater than a certain value and continues for a predetermined period of time.

In addition, in the present invention, the drive source for longitudinal motion and the J for rotational motion
Although a K dynamic source is required, it is of course preferable to include a detection means such as a variable resistor 17, 21, etc., but it is not essential. (If the detection means is not used, the drive source is directly controlled by appropriate signals.) In the above embodiment, the variable resistor 17, etc. and the motor 18, etc. are attached to separate rollers. However, they may be connected to the same roller.

Further, the present invention can be applied to both flexible endoscopes and rigid endoscopes, and can be applied not only to medical endoscopes but also to industrial endoscopes. Furthermore, it can also be applied to insertion of tubular parts in medical instruments such as probes and catheters. Further, it can be applied not only to guiding when inserting the device, but also to withdrawing the inserted device.

Note that the drive motors 18 and 22 are configured to be controlled by electric signals output from the control device section 5;
Set the approximate waveform of the electric signal (so that the change over time is gradual), detect the load of motor J18.22 that is being driven while being controlled by the electric signal, and detect the load of the In addition to the electric signal, an electric signal that gives (micro) vibration is superimposed, and the (micro) vibration that reduces the load in the insertion direction is generated (by changing the signal of the function generator within a certain range and selecting the most appropriate one within that range). It is also possible to configure it so that it can be inserted selectively. By repeating this process, it is possible to gradually generate more appropriate insertion operation signals, and the pain caused to the patient can be significantly alleviated.

Note that the rollers 13°13 attached to the first bearing 12,
-, 13 are installed so that each shaft is pressed inward with a constant force, these rollers 13, 13°..., 1
It is possible to cope with the case that the tubular part such as the insertion part 3 that is moved forward and backward in contact with the insertion part 3 has some irregularities or has a different outer diameter. Regarding each roller 13 to which the variable resistor 17 or motor 21 is attached, the variable resistor 17 and the like can be attached by biasing the portion inward.

Furthermore, the 12 first bearings and the 14 second bearings can be attached and detached to accommodate tubular parts with greatly different outer diameters. Furthermore, the tubular portion is not limited to a cylindrical shape, but can also be applied to a prismatic shape.

Incidentally, a drive system in which only one side is formed also falls within the scope of the present invention.

〔Effect of the invention〕

As described above, according to the present invention, the drive source for longitudinal and rotational motion in the device for inserting an endoscope is configured to be appropriately controlled, so that fine vibrations etc. can be applied depending on the 6th position of the insertion table. It has the advantage that it can be easily inserted and withdrawn with less friction; it also causes less pain to the patient. Furthermore, since the insertion portion has a large diameter, it can be inserted into narrow areas. moreover,
The present invention has the advantage that it can also be applied to conventional general endoscopes. In addition, appropriate insertion operations can be performed depending on the insertion site, and the device can be applied to a wide range of insertion applications.

[Brief explanation of drawings]

1 to 6 relate to one embodiment of the present invention, FIG. 1 is a schematic perspective view showing how the first embodiment is actually used, and FIG. 2 shows the main body of the advancement/retraction device of the first embodiment. FIG. 3 is a partially cutaway front view of the advancing/retracting device main body in one embodiment, FIG. 4 is a block diagram showing the configuration of the control device in one embodiment, and FIG. 5 is an insert. FIG. 6 is an explanatory diagram showing temporal changes when the front and rear handles are driven back and forth during operation. FIG. 6 is an explanatory diagram showing temporal changes when the rotation 9-ra is rotationally driven during insertion operation be. 1...Advancing/retracting (guiding) device, 2...Endoscope, 3...
... Insertion part, 4... Advancement/retraction device main body part, 5... Control device part, 6... Light source, 12... First bearing,
13... (For longitudinal motion) roller, 14... Second bearing, 15... (For rotational motion) roller, 17.21.
...Variable resistor, 18.22...Motor, 19.
23... Cable, 31... Constant voltage source, 3
2.33... Voltage controlled oscillator, 34.35... Amplifier, 38°39... Head, 40-...,
Tape, 41.42...M width device, 43.44.
...Phase comparator, 45°46... (low pass) filter. Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5- Fig. 5 Fig. 6 Continued from page 1 0 Inventor Takeaki Nakamura 2-43-2 Hatagaya, Shibuya-ku, Tokyo Lymphus Optical Industry Co., Ltd. 0 Inventor: Akifumi Ishikawa, 2-43-2 Hatagaya, Shibuya-ku, Tokyo, Lymphus Optical Industry Co., Ltd.

Claims (1)

Scope of Claims: (1) In an advancement/retraction guiding device for advancing and retracting a tubular portion of a device or instrument such as an endoscope inserted into a body cavity or a lumen, the tubular portion is attached to a main body portion that holds the tubular portion. At least one of a drive system is provided, which is a drive system that enables movement back and forth along the longitudinal direction, and a drive system that rotates the drive system around the longitudinal direction, and is integrated with or separate from the main body. 1. An advancement/retraction guidance device for an endoscope, etc., characterized in that it is provided with a control section that allows the system to be controlled by signals. (2) The advancement/retreat guidance device for endoscopic vision, etc. according to claim 1, wherein the control section has means for outputting the signal. (3) The advancement/retraction guidance device for an endoscope or the like according to claim 1, wherein the control section has means for forming the signal. 7(4) The endoscope or the like according to claim 1, wherein the main body portion or the control portion is provided with means for detecting at least one of the amounts of longitudinal and rotational drive. Advance/retreat guidance device. (5) The signal output means is 1. The advancement/retraction guidance device for an endoscope or the like according to claim 2, characterized in that it is formed by reading out or reproducing a recorded signal. (6) The means for forming the signal is such that the advancing/retracting guidance device is attached to a device or instrument such as an endoscope and the device or instrument is operated to advance or retreat, thereby recording a signal corresponding to the operation. An advancement/retraction guidance device for an endoscope or the like according to claim 3, characterized in that the device is formed by: (7) The advancement/retraction guidance device for an endoscope or the like according to claim 3, wherein the means for forming the signal is formed from a signal from a function generator.