JPS6349123A - Colon endoscope - Google Patents

Abstract

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

Description

DETAILED DESCRIPTION OF THE INVENTION (Field of Industrial Application) The present invention relates to a colonoscope that is inserted into the large intestine and capable of observing and treating cancer, polyps, etc. in the large intestine.

(Prior Art) Colon cancer is on the rise in Japan as well with the westernization of the diet.

Colon cancer often develops from colon polyps that protrude within the lining of the colon, and colon polyps have traditionally been observed and removed using a colonoscope. It is thought that the use of mirror-based colon examinations and colon polyp removal treatments will continue to increase.

Conventionally, a colonoscope has a schematic configuration as shown in FIG. 6. In FIG. 6, a colonoscope 51 has an operation handle near its base that can be manually operated by a doctor. 52, an eyepiece lens 53 can be arranged near the operation handle 52, and the eyepiece lens 53
The inside of the large intestine is observed by a doctor operating the operating handle 52 and inserting the distal end of the long tubular tube 54 into the human large intestine through the anus while visually observing the large intestine.

The tube section 54 of the colonoscope 51 is formed of a cylindrical outer skin section 55 made of a flexible material and has an inner diameter that can be inserted into the large intestine. Several operating wires 56 are disposed along the length of the tube 54 at appropriate angular intervals on the periphery of the wall.
The tip of each wire 56 can be bent vertically and horizontally, and the other end of each wire 56 is connected to the operating handle 52, and when the doctor operates the operating handle 52,
When each wire 56 is loosened or pulled, the tip of the tube portion 54 is manipulated in the vertical and horizontal directions, and the tube portion 54 is
The tip of the tube is inserted into the large intestine along the curvature of the large intestine.

A pair of light guide glass fibers 57 are disposed within the outer skin 55, and a lens 57a is attached to the tip of each light guide glass fiber 57. Glass fiber 57 for this light guide
The other end is connected to an external light source device K, and the light emitted by the light source device passes through the light guide glass fiber 57 and is projected into the large intestine from the lens 57a at the tip.

To prevent this, an observation glass fiber 58 is disposed inside the outer skin part 55 in parallel with the light guide graph fiber 57, and an objective lens 59 is attached to the tip of the observation glass fiber 58. It has a structure that allows it to be attached and observe the inside of the large intestine. Observation glass fiber 58
The other end is connected to the eyepiece lens 53. That is, light is projected into the large intestine from the tip of the light guide glass fiber 57, and the light causes the objective lens 59
The image of the inside of the large intestine is visually observed through the observation glass fiber 58 through the eyepiece lens 53.

On the other hand, an air/water supply pipe 60 is disposed inside the outer skin part 55 in parallel with this glass fiber 58 for observation. The other end of the air and water pipe 60 is connected to an external air and water pump U, and air or water is sent into the pipe 60 from the air and water pump U, and air is pumped into the large intestine from its tip. Or it has a structure that sprays water. This air and water supply pipe 60
An air/water supply switch 60a is read directly, and when the doctor turns on the air/water supply switch 60a, air or water is ejected from the tip into the large intestine.

At the same time, suction is applied parallel to this air/water supply pipe 60.

A vibro 1 for forceps is provided. This suction.

The other end of the forceps vibro 1 is connected to an external suction device, and has a structure that allows feces, air, and liquid present in the large intestine to be suctioned to the outside. On the other hand, this suction
The forceps vibro 1 has a branched forceps port 62 that communicates with the forceps port 62, and from this forceps port 62, biopsy forceps for biopsying cancer or polyps, high-frequency snares for removing polyps, and for removing foreign bodies in the large intestine and recovering polyps are used. Grasping forceps etc. are suction, forceps vibro 1
It can be inserted inside. When removing polyps, etc.,
A high-frequency resection snare is inserted through the forceps port 62 and connected to an external high-frequency cauterization power supply, and the high-frequency ablation power supply supplies high-frequency waves to the snare, and the high-frequency waves remove polyps and the like in the large intestine. Also, this suction,
A suction switch 61a is connected to the forceps vibro 1, and when the doctor operates the suction switch 61a, suction of feces and air in the large intestine is started.

The conventional colonoscope 5 shown in FIG. 6 and configured in this way
1, a colonoscope using a light-receiving element CCD has appeared in recent years, and an example thereof is shown in FIG.

A colonoscope using a CCD is the colonoscope 51 shown in Figure 6.
The mechanical structure is almost the same, but the light source device K is red,
A rotating filter 63 composed of three colors, blue and green, is installed, and from this rotating filter 63, red, green, and blue light is sequentially transmitted at high speed through the light guide glass fiber 57 to the lens 57a at the tip. When the projected light is projected into the large intestine and onto the polyp T in the large intestine, an image of the polyp T is captured by the CCD 64 installed in the outer skin part 55 via the objective lens 59, and this COD The images are then sent to an external image processing device 65, etc., which performs arithmetic processing and stores the red, green, and blue images, respectively, and these stored images are installed externally. It can be displayed on a TV monitor R etc. Further, the images may be stored in a video or storage floppy disk, or may be left as photographic images in a camera installed outside.

(Problems to be Solved by the Invention) When observing the inside of the large intestine using the colonoscope 51 configured as described above, the colonoscope 51 is
The tip of the tube portion 54 is inserted into the large intestine, and the operation handle 5 is inserted into the large intestine.
2 is operated, the tip of the tube portion 54 is appropriately rotated and pushed into the large intestine.

This situation is shown in Figure 7. The human large intestine 70 is shown in Figure 7 (
It has a shape like a), extending from the anus 71 to the cecum 74.
There are curved parts (a), (b), and (tsu) between the anus 71 and the curved part (a), and the sigmoid colon 72 exists between the anus 71 and the curved part (a). The space between (1) and (2) is the transverse colon 73. This sigmoid colon 72 and transverse colon 7
3 is not fixed to the abdominal wall and is suspended in the abdominal cavity by the mesentery, and the colon wall is flexible, so
It is difficult for the tip of the colonoscope 51 to pass through the sigmoid colon 72 and the transverse colon 73, and requires considerable skill.

That is, in FIG. 7(b), when the tube portion 54 of the colonoscope 51 is pushed into the sigmoid colon 72, the sigmoid colon 72 is pushed into the sigmoid colon 72 as shown in FIG. 7(c) due to the upward pushing force. Because it is curved upward, the curved part (A) becomes more acute, and it is extremely difficult to pass through this curved part (A). Similarly, when passing through the transverse colon 73 in FIG. 7(d), the transverse colon 73 curves downward due to the pushing force as shown in FIG. 7(e), so there is a curved part.
The angle was more acute, making it difficult to pass. Therefore, passing the colonoscope 51 into the large intestine requires considerable skill and a long time, during which time the patient is forced to suffer, and when the colonoscope 51 is forced into the large intestine, it breaks the lining of the large intestine. There has been a problem in that the insertion of a colonoscope is extremely difficult due to the risk of perforation.

(Means for Solving the Problems) The present invention has been devised in view of the above-mentioned conventional problems. The purpose is to provide a colonoscope that has a propulsion mechanism that allows the tip of the tube to be propelled inside the colon wall, and the gist thereof is to provide an objective lens for observing the large intestine, a tip operation means that can adjust the direction of the tip, A colonoscope having a flexible tube section that can be inserted into the large intestine, the colonoscope having a flexible tube section on the outer periphery of the tube section that is capable of expanding and contracting outward from the outer circumferential surface of the tube section. Two or more wavy pushing parts are formed along the longitudinal direction of the tube part at appropriate intervals, so that the distal end of the tube part can be pushed into the large intestine by repeating expansion and contraction.

(Function) On the outer peripheral surface of at least the distal end of the tube of the colonoscope, two or more wave-shaped propulsion sections are formed along the longitudinal direction of the tube at appropriate intervals. , as this wavy propulsion section repeatedly expands and contracts outward of the tube,
The outer periphery of the wavy propulsion section comes into contact with the inner wall of the large intestine and has the effect of pushing the tip of the tube forward in the direction of movement, so that the tip of the tube is successively pushed forward and can advance sequentially within the inner wall of the large intestine. It is something. Incidentally, at least one pair of wavy propulsion parts are formed in the longitudinal direction along the outer periphery of the pipe part, but the number of these propulsion parts can be increased to three or four, etc., and the number can be increased. By being able to do so, the propulsion force can be further increased.

Further, the propulsion portion may be constituted by a wavy outer skin formed in a wavy shape and made of soft membrane material, and a plurality of inner bag portions formed in a bag shape and contained within the wavy outer skin, and further ,
The wavy outer skin can be formed with a number of outwardly protruding propulsion barbs on its outer peripheral surface. Furthermore, a liquid feed pipe is connected to each of the inner bags, and an injection suction pump is connected to the tip of the liquid feed pipe, so that the pressure liquid passes through the liquid feed pipe through the injection suction pump and flows into each inner bag. If the injection suction pump is programmed to operate sequentially at appropriate timings, the pressure liquid can be supplied to each interior part in sequence through multiple liquid delivery pipes, and can be supplied to each inner bag part in sequence. is inflated, and the wavy outer skin can be made to bulge in a wave-like manner from the forward side to the rear side, and as the waves due to the bulge move backward, pressure fluid is suctioned sequentially from the injection suction pump, and each By sequentially extracting the pressure fluid inside the inner bag from the front side, the wave movement of the wavy outer skin reliably moves from the front to the rear.
The propulsion barbs provided on the wavy outer skin press the wall of the large intestine in accordance with this backward wave movement, thereby making it possible to move the tip of the tube of the colonoscope forward. Furthermore, when the tube is removed from the large intestine, all the pressure fluid is sucked out by the injection suction pump, so each inner bag and the wavy outer skin are stuck to the outer wall of the tube, reducing the overall outer diameter. The colonoscope can be easily removed from the colon. At that time, the propulsion pleats are in close contact with the wavy outer skin and do not interfere with pulling out.

(Example) Hereinafter, one example of the present invention will be described based on FIGS. 1 to 5.

FIG. 1 shows an enlarged view of the distal end of the tube portion 1a of the colonoscope 1, (a) shows a side view of the distal end, and (b) shows a front view of the distal end.

In the figure, at the tip of the tube section 1a of the colonoscope, there is an objective lens 59 for observing polyps in the large intestine, similar to the conventional colonoscope 51, and a tube section 1a passes through the large intestine. An air/water supply nozzle 60a for feeding air or water into the large intestine for easy cleaning, a suction forceps port 61 for sucking feces, etc. in the large intestine, and inserting forceps, etc., and a light for illuminating the inside of the large intestine. A lens 57a is arranged, which is the same as in the conventional case. Furthermore, in this example, the pipe portion 1
At the tip of a, four pressure sensors Ca, Cb, Cc, and Cd are arranged along with the objective lens 59 and the like. These four pressure sensors Ca, Cb, C
c, Cd are arranged at 90° intervals on the circumferential surface of the tip of the tube portion 1a, pressure sensor Ca can sense the upward pressure, pressure sensor Cc can sense the downward pressure, pressure sensor cb can sense the pressure on the right side, and the pressure sensor Cd is arranged so that it can sense the pressure on the left side.

Each of the pressure sensors Ca, Cb, Cc, and Cd is covered with a flexible thin film 3, and each film 3 is formed in the shape of a bag that projects outward, and there is liquid inside the film. 4 is included. Therefore, when each membrane 3 comes into contact with the inner wall of the large intestine, this membrane 3
is pushed out and pressure is applied to the liquid 4 inside, and the pressure is sensed by each pressure sensor Ca, Cb, Cc, and Cd via this liquid 4.

Further, wires Wa, Wb similar to the conventional ones are placed outside the pressure sensors Ca, Cb, Cc, and Cd.

Wc and Wd are respectively provided. Therefore, by pulling the wire Wa, the tip of the tube portion 1a can be bent upward, and conversely, by pulling the wire We, the tip of the tube portion 1a can be bent upward.
The tip of a can be bent downward. Similarly, the tip of the tube portion 1a can be bent to the right by pulling the wire wb, and to the left by pulling the wire Wd. The tips of each of the wires Wa, Wb, Wc, and Wd are connected to an operating handle 2 at the other end of the tube portion 1a, and the operating handle 2 has a handle 2 that can be rotated to an appropriate angle. Motors M (not shown) are connected to each other. Therefore, one of the two motors M can control the wires Wa and WC, and the other motor M can control the wires Wb and Wd.

Furthermore, in this example, four propulsion parts Sa, Sb, Sc,
Sd is provided. These propulsion parts Sa, Sb, Sc
, Sd are the respective pressure sensors Ca, Cb, Cc,
They are disposed at 90° intervals at each outer position of the tube portion 1a, and are formed to have an appropriate length along the longitudinal direction from the tip end of the tube portion 1a. The details are shown in Figure 2.

That is, to explain the propulsion section Sa located at the upper side in FIG. 2 as an example, the propulsion section Sa has a wavy outer skin N, N, . Bag-shaped inner bag portions Fs, Fx, F3 . F4. Fa, Fa, and liquid feed pipes E, , E, , E, capable of supplying pressure liquid into the respective inner bag portions F+, Fz, Fs, F-, Fa, and Es.

The wavy outer skins N, , N, . . . are formed of a flexible thin film material, and each wavy outer skin Nl, Nt, . A large number of propulsion pleats 6 inclined rearward are planted on the outer surface of the vehicle. This large number of propulsion pleats 6 are wavy outer skins N r , N 2
When ... is contracted to the outer skin part 55 (11) of the tube portion 1a, the wavy outer skin Nr, N-... falls to the side, and when the wavy outer skin N,, N, is expanded, It is configured to stand up.

On the other hand, each inner bag portion F,,F,,F,,F,,F,,F,, which is disposed within the wavy outer skin NH, N1,... . . . 6 pieces are arranged inside each of them, and the interior part F in the center is formed into a tall bag shape that protrudes most outwardly, and this F, the inner bag part F with a lower awn. , , F are arranged on both sides, and F, , F with a lower height are arranged further outward.

These inner bag portions Fl, F2. By supplying pressure liquid into FS, Fa, Fs, and Es, each inner bag portion FII Fm
l Fil Fa1 Fil FS can expand to cause the wavy skins N + , N * . . . to bulge outward.

Each liquid feed pipe E, E, E, E, for supplying pressure liquid into the inner bag portion F,, F,, F,, F,, F,, F,
, Ea, and El are each piped in the outer skin part 55 along the longitudinal direction of the pipe part 1a, and each wavy outer skin N I,
Each corresponding inner bag portion Ft in Nz...
+Fil It has a branched piping structure that can simultaneously supply pressure liquid into Fs, Fa, Fs, and Es. Each of these liquid feed pipes E I'HE 1 g E s g E 4g
E s HE, and a plunger pump Pr r P ! at the other end, respectively. l P s + P a + P
a r P s are connected, and each plunger pump Flu Pz, Ps, Pa, P6. By activating Pl, each liquid feed pipe E+, E! ,
Pressure liquid is supplied or sucked into Es, Ea, Ea, and Ea. Therefore, this pair of plunger pumps PI, P! , Ps, Pa, P5. P, are installed in pairs of 6 units for each of the propulsion parts Sa, Sb, Sc, and Sd, for a total of 4 pairs, and each plunger pump P l * P ! +Ps, P4. Pa
, Ps are read by an external microcomputer 7 and their operations are controlled. In other words, six plunger pumps P constitute a pair of injection/suction pumps P.
+ + P * + P s + P a + P s
, Ps are set to be operated sequentially from plunger pump P toward P6 at regular timing intervals, and the inner bag portion F l +Fz, Fs
Pressure fluid is sequentially supplied into the inner bag portion FII Fil.
The structure is such that the FS is inflated in order from the front, and the program is such that when the inner bag part F4 is inflated, the pressure fluid is sequentially extracted from the inner bag parts F+, Fz, and Fs. Therefore, each inner bag portion Fl, F*, F-, FA, Fa, F
By sequentially expanding and contracting s, each wavy outer skin Nt, N
*... repeats expansion and contraction so that the waves move sequentially from the front to the rear. At that time, the wavy outer skin N...
A large number of propulsion pleats 6 provided in Nz... are each erected and abut against the large intestine wall 70, allowing the tube portion 1a of the endoscope to be propelled forward. Also, when curving inside the large intestine wall 70, the injection suction pump P on the curving side
It is programmed so that the pressure of the injection suction pump P on the opposite side is increased while the pressure of the injection suction pump P on the opposite side is increased, ensuring ease of propulsion during curves.

FIG. 3 shows the state when curving inside the curved part of the large intestine wall 70.

In FIG. 3, the pressure sensor Cc is attached to the inner wall 70 of the large intestine.
When the two contacts come into contact, this pressure sensor CC detects the pressure and issues a pressure signal to the microcomputer 7. In response to the pressure signal, the microcomputer 7 drives the motor M, which pulls the wire Wa disposed on the pressure sensor Ca side, and conversely causes the pressure sensor Cc to be pulled.
The side wire We is loosened. Therefore, the distal end of the tube portion 1a of the endoscope is bent to the right. Corresponding to the bending state, the hydraulic pressure in the propulsion section Sa is weakened, and conversely, the hydraulic pressure in the propulsion section Sc is weakened.
By increasing the fluid pressure, the tip of the tube portion 1a of the endoscope can be curved and propelled along the curved portion of the large intestine wall 70.

Next, FIG. 4 shows an example of the arrangement and configuration of the colonoscope 1 according to the present example in a block form.

That is, the colonoscope 1 of this example includes the pressure sensor Ca.
, Cb , Cc , and Cd are installed, as well as an objective lens 59 and a CCD 64 that converts an image from the objective lens 59 into an electrical signal. A microcomputer 7 is connected to the pressure sensors Ca, Cb, Cc, and Cd, and each wire Wa, Wb, We, and Wd is connected to the microcomputer 7.
Two operating motors M are connected to the microcomputer 7 for operating the liquid feed pipes E, , E.
,,E$1 E41 Ea1 Plunge loop pump for supplying pressure fluid to Ea P,,P,,P,,P,,P
6. Four pairs of injection/suction pumps P constituted by Ps are disconnected. Further, the microcomputer 7 is connected so that it can also control the intake water pump U, which is similar to the conventional one. In addition, a light guide type fiK similar to the conventional one is connected to the colonoscope 1, and this light guide type gK is provided with a rotating filter 63 to display red, blue,
It is capable of supplying green light to the colonoscope 1.

Furthermore, the video signal supplied from the CCD 64 inside the colonoscope 1 is configured to be sent to an external observation image processing device 65, and a television monitor, video R, etc. can be connected to this image processing device 65. The structure is sharp.

The microcomputer 7 is a well-known microcomputer, and basically includes a CPU 7a and a RAM 7b.
, ROM 7c, and a program for controlling the CPU 7a' is written in the ROM 7c, and the CPU 7a takes in pressure signals from the pressure sensors Ca, Cb, Cc, and Cd according to this program, or inputs pressure signals from the pressure sensors Ca, Cb, Cc, and Cd, or inputs pressure signals from the pressure sensors Ca, Cb, Cc, and Cd. It performs arithmetic processing while exchanging data, and outputs the processed data to the operation motor M and the injection/suction pump P as necessary.

Next, FIG. 5 shows R in the microcomputer 7.
A flowchart shows a program written in the OM7c.

FIG. 5(a) shows the main program of loop 1. In the figure, the tip of the tube section 1a of the colonoscope 1 is located at the anus 7 of the large intestine.
When the switch installed in the colonoscope 1 is turned on while the colonoscope 1 is inserted into the colonoscope 1, the microcomputer 7 reads detection signals from the pressure sensors Ca, Cb, Cc, and Cd (step 1). ). Based on this detection signal, the computer 7 determines whether all pressure sensors Ca, Cb, Cc, and Cd are unable to detect pressure (step 2). If it is determined that no pressure is felt by any pressure sensor,
An operating signal is generated from the microcomputer 7 for the propulsion injection suction pump P, and the output is exhausted, and a free position operating signal is generated for the operating motor M to set each wire Wa, Wb, Wc, and Wd in a free state. The output is finished (step 3). Based on these operating signals, the operation motor M sets the wires Wa, Wb, Wc, and Wd in a free state, and the injection suction pump P is in a propulsion state, that is, all liquid pressures are made uniform, and as described above, each liquid feed pipe El, E2. E
Pressure liquid is sequentially fed to s+ Et* Ex+ Ea and suctioned sequentially to cause the wavy outer skins N, , N, . Thus, the tip of the tube portion 1a of the endoscope advances straight along the inner wall of the large intestine (step 5).

On the other hand, when the microcomputer 7 determines that pressure is detected by any of the pressure sensors Ca, Cb, Cc, and Cd, it determines which pressure sensor has detected the pressure (step 6), and based on that, it determines which pressure sensor has detected the pressure. An operating signal is generated and outputted to rotate the wire operation motor M in a direction to loosen the wire on the side of the detected pressure sensor and pull the wire on the opposite position side. At the same time, the output of each thrusting plunger pump P+, Pt, Ps, etc. on the sensor side that detected the pressure is allowed to increase with respect to the injection suction pump P, and each plunger pump P+ on the opposite position side is allowed to increase.
, Pz, Ps... generates a signal that reduces the output of
Output (step 7). The wire operation motor M and the injection suction pump P are operated according to these operation signals (
Step 8). That is, for example, the pressure sensor C on the lower side
When pressure is felt at c, the operating motor M is rotated in the direction of loosening the wire We and pulling the wire Wa, increasing the hydraulic pressure supplied to the lower propulsion section Sc, and increasing the hydraulic pressure supplied to the upper propulsion section Sc. The injection suction pump P is activated so that the liquid pressure supplied to Sa is reduced. Therefore, the distal end of the tube section 1a of the endoscope is bent upward, and the propulsive force of the propulsion section Sc is strengthened, so that the distal end of the tube section 1a can be smoothly advanced upward. Next, it is determined whether the operating force of the wire operation motor M is less than or equal to a predetermined value (step 9). When an actuation force greater than a predetermined value is applied, processing can be completed according to a loop 2 program to be described later. If the operating force of the wire operation motor M is below a predetermined value, the tip of the tube portion 1a is moved forward in an upwardly bent state according to the operation in step 8 (step 1).
0). After this forward movement, either pressure sensor Ca,
When pressure signals are detected from Cb, Cc, and Cd, step 6, step 7, and step 8 are performed in the same manner as above.
Each operation is performed sequentially, and the tip of the tube portion 1a moves forward while being bent in an appropriate direction, and the bending progress in steps 6, 7, and 8 is repeated a predetermined number of times in the same pattern consecutively within a predetermined time. It is determined whether it has been repeated or not (
In step 11), when the same pattern is repeated a predetermined number of times or more, processing is performed by a loop 3 program to be described later. When it is determined that the same pattern has not been repeated more than a predetermined number of times, the process returns to step 1, and the main program of loop 1 is repeated. 70 and will gradually move forward.

Next, in loop 2 shown in FIG. 5(b), when it is determined that the operating force of the wire operation motor M in loop 1 is greater than or equal to a predetermined value (step 9), that is, the tip of the pipe portion 1a is bent. In this case, the propulsion infusion/suction pump P is turned off.
F, and the liquid in each liquid feed pipe El, E, , E, , E, . . . is collected into each plunger pump P, , P, , P, .

Furthermore, each wire Wa for the wire operation motor M
, Wb, Wc, and Wd are issued, and each wire is set in a free state (step 12). In this state, it is determined whether a certain period of time has elapsed (step 13). When a certain period of time has passed and the tube portion 1a returns to its normal position due to the self-produced large intestine, the process returns to the main program of loop 1 (step 1).
4). However, if the operating force of the wire-operated motor M still exceeds the predetermined value even after a predetermined period of time has elapsed (step 15), the injection suction pump P for propulsion is completely turned off, and the pressure fluid is supplied to each plunger pump P+. ,
Pg, Ps... are collected in each wire Wa,
Wb, We, and Wd are completely freed (step 16). In this state, an alarm constituted by an external LED or buzzer is activated (step 17). In this state, the tip of the tube portion 1a is likely to be quite firmly caught on the wall of the large intestine wall 70, so the doctor should turn the switch to 0FFt and remove the colonoscope from the large intestine. There are many.

Next, FIG. 5(c) shows a program for loop 3. That is, the program in loop 3 is a control procedure in a state (step 11) in which the distal end of the tube portion 1a repeats the same pattern many times in a predetermined period of time in the large intestine. For example, a case where the distal end of the tube portion 1a comes into contact with a blind alley within the large intestine wall 70 can be considered as a case where this occurs. That is, in such a case, a command signal for rotating the wire operation motor M in the direction of loosening the wire on the sensor side at a position shifted by 90 degrees and pulling the wire on the opposite side is operated by the microcomputer 7. output to motor M,
At the same time, a command signal is output to the injection and suction pump P to increase the output of the propulsion injection and suction pump P on the sensor side that is 90° shifted, and to decrease the output of the injection and suction pump P on the opposite position side ( Step 18). According to the command signal in step 18, the wire operation motor M is activated, and the injection suction pump P is activated (step 19).
), that is, for example, the tip of the tube 1a reaches a dead end in the large intestine wall 70, and, for example, the pressure sensor Ca and the pressure sensor Cc located on the opposite side contact the large intestine wall 70, and the tip of the tube 1a moves up and down. When it is no longer possible to move in that direction, it may be possible to escape from the bag 7J% road if it is in the left or right direction. Loosen the wire wb located in the left and right direction, pull the wire Wd on the opposite side, and proceed accordingly. The propulsive force of the section sb is strengthened, and the propulsive force of the opposing propulsion section Sd is weakened to cause the tube section 1a to curve in the left-right direction. When the normal state is restored by such an operation, the loop 1 repeatedly moves forward according to the main program (step 20). However, in the left-right state as well, when the curved movement continues in the same pattern many times within a predetermined time (step 21), the injection suction pump P for propulsion is turned OFF, and each liquid feed pipe E I + E□, E
,,E,... The liquid in each plunger pump PI
It can be recovered within ,P,,P,... Furthermore, the wire operation motor M is rotated to the wire free position, and each wire Wa, Wb, Wc, and Wd is set in a free state (step 22). That is, in this state, there is a dead end in both the left and right directions, and the tip of the tube portion 1a is no longer able to move forward in either direction. In this state, it is determined whether or not a certain period of time has elapsed (step 23), and when the forward direction is secured by self-creation of the large intestine after the elapse of a certain period of time, processing is performed according to loop 1 of the main program (step 23). 24
). However, when the curve continues to be repeated after a certain period of time, it is no longer possible to move forward, so after this decision is made (step 25), the injection suction pump P for propulsion is completely turned off. and the pressure fluid is collected into each plunger pump Pr, P*+P*... Furthermore, the operating motor M is placed in a wire free state (step 26). At this time, an alarm is emitted from an external LED or buzzer, etc. (step 27).
).

Next, loop 4 is shown in No. 5130 (d) as an emergency program.

That is, when each pressure sensor Ca, Cb, Cc, Cd feels a pressure above a certain level, or when all pressure sensors Ca
, Cb, Cc, and Cd (step 28), the odor technician turns off the injection suction pump P and pumps the propelling pressure fluid into each plunger pump P+, Pa, and P.
s... and wire-operated motor M
is placed in the free state of the wire (step 29).

That is, there is a case where the distal end of the tube portion 1a of the endoscope comes into contact with any of the large intestine walls 70 and becomes wedged.

At such times, it is determined whether a certain amount of time has elapsed (
Step 30) After a certain period of time, it is determined whether or not the pressure has returned to a normal state that allows for forward movement (Step 31).
), and when it is determined that the normal state has returned, the main program of loop 1 is returned (step 32). When the pressure sensor still feels a pressure higher than the predetermined value, it is confirmed that the injection suction pump P is completely turned off and the wire is left in a free state (step 33).
At the same time, an alarm will be sounded on the external LED or buzzer, etc. (
Step 36). There are also times when the switch can be turned off (step 34).

Further, steps 33 and 34 can also be activated when the stop switch operated by the doctor is turned on (step 35). That is, the time when the doctor turns on the stop switch is when the tip of the tube portion 1a reaches the caecum of the large intestine, etc.
During the forward movement, when it is desired to supply air or water into the large intestine, or to suction feces, etc., the stop switch is turned on as appropriate after observing the patient's state of pain.

As described above, in the colonoscope 1 of this example, the pressure sensor Ca is provided at the distal end of the tube portion 1a.

The pressure in the forward direction within the large intestine wall can always be detected by Cb, Cc, and Cd, and the forward direction of the tube portion 1a is automatically guided.
Sd allows the tube portion 1a to advance well within the large intestine wall 70,
The distal end of the endoscope is not forced into the colon as in the past, and the distal end of the endoscope is passed through the colon wall 70 without causing pain to the patient. It can be observed that

In addition, the propulsion parts Sa, Sb, Sc, and Sd are 4 in this example.
Although three pieces can be arranged, the number is not limited.

Furthermore, each of the wavy outer skins N, N, .
1. A bag-shaped inner bag portion F provided inside N*...
,F,,F3. F, , Fs, and F can also be formed integrally.

Further, in this example, a rotating filter 63 is provided in the light guide power source K to transmit red, blue, and green light to the colonoscope 1.
However, instead of using the rotary filter 63, a structure using a pair of three color light receiving elements CCD that can convert each red, blue, and green light into an electric signal. You can also do it. In that case, the white light is projected into the colon from the lens at the tip by the light guide power source through the glass fiber for the relight guide, and when this projected light is projected onto the polyp T etc. in the colon, the objective An image of the polyp T is captured by a pair of three CCDs through a lens, and the image is sent from each CCD to an external image processing device or the like for processing. Note that the number of light guide glass fibers is not limited to that in this example, and may be one.

Furthermore, instead of the pressure sensors Ca, Cb, Cc, and Cd, a temperature sensor, a light/dark sensor, a tactile sensor, or the like may be used. In other words, when the temperature sensor is replaced with a pressure sensor, the structure is such that air at a temperature lower than body temperature is blown out near the temperature sensor, and when the low-temperature air comes into contact with the inner wall of the large intestine, the low-temperature air is Since it is heated and sensed by a temperature sensor, it is possible to sense the direction in which it should travel within the wall of the large intestine. The light/dark sensor makes judgments based on the intensity of light projected onto the inner wall of the large intestine, and the tactile sensor makes judgments based on the sense of touch.

It is also possible to insert into the control program in this example a program that operates the air and water pump U at appropriate times, and by operating the air and water pump U, the large intestine wall 70 is supplied with air or water. It is possible to improve the progress of the tip of the tube portion 1a by expanding the tube portion 1a.

(Effects of the Invention) The colonoscope of the present invention includes an objective lens for observing the large intestine and a tip operation means that can adjust the direction of the tip, and has a visible tube part that can be inserted into the large intestine. The mirror includes a tube on the outer periphery of the colonoscope that is capable of expanding and contracting outward from the outer circumferential surface of the tube, and is capable of pushing the tip of the tube into the large intestine by repeatedly expanding and contracting. Two or more wavy propulsion parts are formed along the length of the tube at appropriate intervals, so the wavy propulsion parts repeatedly expand and contract as they move through the tube of the colonoscope. The tip of the tube can be advanced easily and smoothly into the large intestine, and the tip of the tube automatically propels the tube into the large intestine, eliminating the need for doctors to forcefully push the tube into the large intestine as in the past. It has the effect of making it easier to insert the tube of the colonoscope, without requiring any skill to insert the tube, and of causing less pain to the patient during insertion. .

[Brief explanation of the drawing]

1 to 5 show one embodiment of the present invention, and FIG.
Figure (b) is a front view of the tip, Figure 2 is an enlarged explanatory view of a similar propulsion section provided at the tip, Figure 3 is an explanatory diagram showing the state in which the tube advances within the large intestine wall, and Figure 4 The figure is a block diagram of the system configuration of this example colonoscope.
C), (D) are flowcharts showing programs written in the ROM in the microcomputer. FIG. 6 is a structural diagram of a conventional colonoscope, and FIGS. 7 (A) and (B). (C), (D), and (E) are explanatory diagrams showing the structure of the large intestine, No. 8
The figure is a configuration diagram of a colonoscope using a CCD. 1... Colonoscope 1a... Tube section 2... Wire operation handle 3... Film 4... Liquid
6... Propulsion pleat 7... Microcomputer - 7c... ROM R... TV monitor K... Power supply for light guide U... Air/water pump M... Wire operation motor P... - Injection suction pump Ca, Cb, Cc, Cd - Pressure sensor Wa,
Wb, Wc, Wd-wire Sa, Sb, Sc
, 5d-=propulsion part N, , N, . . . wavy outer skin Fl, F2. F,,F,,F6. Fs...Inner bag part EI
＋E! +E3. E4. E6. E6...Liquid feed pipe p,
,P,,P3. P4. Pa, P,... Plunger pump 55... Outer skin portion 59... Objective lens 60a... Air/water supply nozzle 61... Suction, Vibro 4 for forceps... CCD special r [applicant small Eiji Hayashi (Left 2) Figure 5 (.) Input Δbup 0FF f; Sakigaku Tsuki Lzkru (Lef '3) (Loop 4) Figure 5 (C) Figure 7 (U)

Claims (2)

[Claims] (1) A colonoscope that is equipped with an objective lens for observing the large intestine and a tip operation means that can adjust the direction of the tip, and has a flexible tube that can be inserted into the large intestine. The outer periphery of the tube is capable of expanding and contracting outward from the outer circumferential surface of the tube.
A colonoscopy characterized in that two or more wavy pushing parts capable of pushing the tip of the tube into the large intestine by repeated contractions are formed along the longitudinal direction of the tube at appropriate intervals. mirror. (2) The propulsion section includes a wavy outer skin made of a flexible membrane material that is formed in a wavy shape and has a large number of outward propulsion pleats, and a bag-shaped inner part of the wavy outer skin that connects the wavy outer skin to a tube of a colonoscope. and a plurality of inner bag parts that can expand and contract outward from the outer circumferential surface, and a pressure liquid is sequentially injected into each of the inner bag parts,
2. The colonoscope according to claim 1, wherein a liquid feeding tube is connected to an infusion suction pump capable of suctioning.