JPS6176129A - Living body measuring apparatus for 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 C. Field of Industrial Application The present invention relates to an apparatus for endoscopically stimulating the inside of a body cavity and measuring the reaction of a living body to the stimulation.

BACKGROUND ART As a conventional technique, a device disclosed in Japanese Utility Model Publication No. 57-22895 is known. This conventional technique diagnoses abnormalities in the autonomic nerves by utilizing the reflex action of the autonomic nerves distributed in the rectal wall of the rectum, which relaxes the anal sphincter muscles when the body senses that defecation is entering the naoislet. This is the defecation function in which the anal sphincter relaxes reflexively due to stimulation when feces enters the rectum during normal defecation.
It is detected by measuring changes in the internal pressure of the anal canal as the sphincter relaxes. This conventional example is shown in FIG. A sphincter muscle 3 exists near the anus 2 of the living body 1. this anus 2
A synthetic resin sleeve 4 is inserted into the rectum, and a tube 6 having an extensible balloon 5 at its tip is inserted through the center hole of the sleeve 4 to stimulate the autonomic nerves in the rectal wall 7. Furthermore, a liquid is inserted between the balloon 5 and the anus 2,
The internal pressure is detected by a pressure transducer 8, the signal thereof is amplified by an amplifier 9, and recorded by a recorder 10.

[Problems to be solved by the invention] In conventional techniques, stimulation using a platform or balloon, where the autonomic nerves of the rectum exist only locally, is too wide, so it is difficult to provide stimulation locally. This made it impossible to detect and diagnose cases. Furthermore, when the deep rectum was stimulated by the balloon, the distance between the balloon and the anus became large, causing pressure to escape and making measurements impossible. This invention was made with attention to these problems, and it is possible to detect the presence or absence of local defects in the autonomic nerve network of the rectal wall, and to reliably measure reflexes regardless of the depth of the stimulated area from the anus. The purpose of the present invention is to provide a biological reaction measuring device for an endoscope that is capable of measuring biological reactions.

Means for Solving Problem E] This device includes a sleeve through which the endoscope is inserted, and the sleeve is provided with at least a sensing section and connected to pressure sensing means. An endoscope is inserted through the sleeve, a stimulator having a plurality of electrodes installed at its tip is passed through the forceps insertion channel of the endoscope, and a stimulation current generating means for flowing a stimulation current is connected to the stimulator. ing.

[Operation] The endoscope is inserted into the sleeve inserted into the anus, the forceps insertion channel of the endoscope is pressed, and the electrode of the stimulator is brought into contact with the wall of the rest cavity, energized, and the stimulation is reflected on the anal wall. Sphincter muscle pressure is taken out from the sensing part of the sleeve and measured.

[Example code] Hereinafter, one embodiment of the present invention will be described based on the drawings.

1 and 2 show a first embodiment of the present invention, and FIG. 1 is a diagram illustrating the entire system according to the present invention. 11
is a sleeve inserted into the anus 2 of the living body 1, and the sleeve 11 has an inner part. ! An insertion hole 12 having an inner diameter slightly larger than the outer diameter of the insertion portion 21 of the mirror 20 is provided. Further, a tube 13 is embedded in the sleeve 11, and the tip of the tube 13 has an opening 14 in the side surface of the sleeve 11.
It is established as. The tube 13 is formed of a flexible tube, and the other end is extended and connected to the pressure transducer 15. This tube 13 is filled with water 16. The pressure transducer 15 is connected to a recorder 18 via an amplifier 17.

On the other hand, a stimulator 30 is installed in the forceps insertion channel of the endoscope 20.
is inserted, protrudes from the forceps port of the distal end portion 22 of the endoscope u120, and the distal end of the stimulator 30 is pressed against the rectal wall 7.

FIG. 2 is a diagram showing the stimulation device 30. As shown in FIG. This stimulator 3
0 has a hollow cylindrical operating section main body 31, and the operating section main body 3
A flexible tube 32 is fixed to one end of 1. This tube 32 has a sufficient length compared to the forceps insertion channel of the endoscope, and has a distal tip 33 fixed to its distal end. A slider 34 is inserted into the operating section main body 31 so as to be slidable in the axial direction, and a grip section 35 of the slider 34 is provided to protrude outward from the operating section main body 31 in the axial direction. Further, grooves 36 and 37 are provided on the circumferential surface of the slider 34 so as to extend back and forth in the axial direction, and engage with a protrusion 38 protruding inward at the rear end of the operating section main body 31, and a hole 39 is opened in the center. There is. A hollow shaft 40 is connected to the flexible tube 32 side of the slider 34, and two stimulation electrodes are attached to the distal tip 33 side of the shaft 40 by a holding part 42.

The holding part 42 is an insulator, and the stimulation electrode 41 is separately buried therein, and the stimulation electrode 41 is curved outward and extends forward. Further, the distal tip 33 is also formed of an insulator and has two openings at the distal end, and a stimulation electrode 41 is passed through each opening.

Furthermore, one electric wire 43 is connected to the stimulation electrode 41, guided to the outside through the shaft 40 and the hole 39 in the slider 34, and connected to the pulse generator 44.

Next, we will discuss the effect. First, the sleeve 11 is positioned in the anus 2, and the insertion section 21 of the endoscope 20 is inserted into the rectum through the insertion hole 12.

The stimulator 30 is inserted through the forceps insertion channel of the endoscope 20 and protrudes from the forceps port at the tip of the endoscope. In this state, the inner gift 1i20 is pushed and pulled, and the slider 34 is pushed until the protrusion 38 enters the groove 37 to make the stimulation electrode 41 protrude from the opening of the distal tip 33.
Expand the tip of 1. By these operations, the needle a electrode 41 is pressed against the measurement site on the rectal wall 7. The sleeve 11 is configured so that the opening 14 on its side is located at the sphincter muscle 3.
Water 1 from tube 13 to pressure transducer 15
Fill with 6.

When a pulse current is applied from the pulse generator 44 in this state, the autonomic nerves in the rectal wall 7 are stimulated by the stimulating electrode 41 from the electric wire 43, causing relaxation and tension of the sphincter muscle 3.

The reflection is detected by the pressure transducer 15 as the pressure of the water 16 in the tube 13 from the opening 14, and is recorded by the recorder 18 via the amplifier 17.

Note that the current generated by the pulse from the pulse generator 44 is several mA and has a pulse width of 1 to 3 seconds. This operation is repeated to diagnose the presence or absence of autonomic nerves in the rectal wall 7.

Next, FIG. 3 is a diagram showing a second embodiment of the present invention. Third
The figure shows a stimulator 50 that is different from the first embodiment. This stimulator 50 has a finger hook 51 at the rear end and an intermediate guide rail 52, and has an operating section main body 55 at the front having a cylindrical section 54 with a hole 53 in the center. A flexible tube 56 is fixed to the front end of the operating section main body 55. A slider 57 is slidably provided on the guide rail 52 of the operating section main body 55, and a pull rod 58 is connected to the slider 57 from the hole 53 to the tube 56. An operating wire 59 is connected to this lead 58 and extended inside the tube 56, exits the tube 5'6 through a hole 60 formed at the distal end of the tube 56, and is spaced from the hole 60 toward the distal end. It returns into the tube 56 through the hole 61 provided therein and is fixed to a stopper 62. At the tip of the tube 56 and on the opposite side of the hole 61, two stimulation electrodes 63 are placed several mm apart.
is fixed, and an electric wire 43 is disposed in a tube 56 from the Ik electrode 63, and is led out from the hole 53 of the operation section main body 55 through a hole 64 provided in the cylindrical portion 54. This electric wire 43 is connected to the pulse generator as in the first embodiment.

This second embodiment is used by being inserted into the forceps insertion channel of the endoscope 20 in the same manner as the first embodiment, and is used by being inserted into the forceps insertion channel of the endoscope 20.
0, the slider 57 is pushed and pulled to push and pull the five operation wires, and the tip of the tube 56 is bent. This bending of the tube 56 makes it easier to press the stimulation electrode 63 against the rectal wall 7. Thereafter, as in the first embodiment, a pulse current is applied to the stimulation electrode 63 from the pulse generator 44, and the reflex of the sphincter 3 is detected by the pressure transducer 15 connected to the sleeve 11.

In the above example, the tube 13 is extended from the opening 14 of the sleeve 11 to the pressure transducer 15 to detect pressure using the liquid 16 as a medium.
It is also possible to provide various pressure-sensitive elements or the like at the position corresponding to 4 and extend a conductive wire to an external detection circuit to serve as a pressure detection means.

[Effects of the Invention] According to the present invention, since a stimulation electrode is provided at the tip of a tube that can be directed to a measurement site through a forceps insertion channel of an endoscope, any localized location in the large intestine can be stimulated. The presence or absence of abnormalities in the large intestine autonomic nerve can be diagnosed with high accuracy. Furthermore, since eight stimulation sites can be selected under direct view of the endoscope, orientation of the stimulation site is extremely easy, and at the same time there is little risk of perforation. Furthermore, the stimulation part is inserted into the anus by a sleeve to create anal sphincter pressure.
Reliable measurements can be made regardless of how shallow or deep the stimulation site is from the anus.

[Brief explanation of drawings]

Fig. 1 is a diagram explaining the overall system of the present invention, Fig. 2 is a diagram showing a stimulator used in the first embodiment, Fig. 3 is a diagram showing a stimulator used in the second embodiment, and Fig. 4 is a diagram showing the stimulator used in the second embodiment. FIG. 1 is a diagram showing a conventional technique. DESCRIPTION OF SYMBOLS 11...Sleeve, 12...Through hole, 14...Opening part, 15...Pressure 1-transducer, 20...
Endoscope, 50.30... Stimulator, 32.56... Flexible tube, 41.63... Stimulation electrode, 44... Pulse generator.

Claims (1)

[Claims] A sleeve into which an endoscope can be inserted, a stimulator having a plurality of electrodes spaced apart from each other at the tip of a flexible tube that can be inserted into a forceps insertion channel of the endoscope, and a stimulation current flowing between the electrodes of the stimulator. A biological reaction measuring device for an endoscope, characterized in that a stimulating current generating means and a pressure detecting means having at least a sensing portion in the sleeve are provided.