JPS6349124A - 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 general configuration as shown in Fig. 6. In Fig. 6, a canine II9 endoscope 5
1 is equipped with an operation handle 52 near its base that can be manually operated by a doctor, and an eyepiece 53 is disposed near this operation handle 52.
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 observing the large intestine 3 visually.

The tube portion 54 of the colonoscope 51 is formed of a cylindrical outer skin portion 55 made of a flexible material and has an inner diameter that can be inserted into the large intestine. Several operation wires 56 are arranged along the longitudinal direction of the tube section 54 at appropriate angular intervals on the periphery of the wall surface, and the tip end of the wire 56 is fixed to the tip end of the tube section 54 so that the tube section 5
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.

Furthermore, an observation glass fiber 58 is housed inside the outer skin part 55 in parallel with the light guide glass fiber 57, and an objective lens 59 is attached to the tip of this observation glass fiber 58 to allow inside the large intestine. The structure is observable. The other end of the observation glass fiber 58 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 an image of the large intestine is visually observed through the eyepiece lens 53 via the objective lens 59 and the observation glass fiber 58.

Further, an air/water supply pipe 60 is disposed in the outer skin part 55 in parallel with the observation glass fiber 58. The other end of the air and water pipe 60 is connected to an external air and water pump U, which sends air or water into the pipe 60 and into the large intestine from its tip. It has a structure in which air or water is injected. This air and water supply pipe 6
An air/water supply switch 60a is connected to the terminal 0, and when the doctor turns on the air/water supply switch 60a, air or water is ejected from the tip into the large intestine.

Suction is applied to the awn in parallel to this air and 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
A forceps port 62 is connected to the forceps vibro 1 in a branched manner, and from this forceps port 62, biopsy forceps for biopsies of cancer or polyps, high-frequency snares for removing polyps, and for removing foreign bodies in the large intestine or recovering polyps are used. Grasping forceps etc. are suction, forceps vibro 1
It can be inserted into 1tt. When resecting a polyp, etc., a high-frequency snare for resection is inserted through the forceps port 62 and connected to an external high-frequency ablation TM and source device, and the high-frequency ablation power supply device supplies high-frequency waves to the snare, and the high-frequency waves Polyps, etc. inside the body are removed. A suction switch 61a is connected to the suction and 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 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 from the lens 57a at the tip. When the projected light is projected into the large intestine and onto a polyp T etc. 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 from this COD. The video is sent to an external image processing device 65, etc.
``A red image, a green image, and a blue image are each processed by the image processing device 65 and stored, and the stored images are displayed on a television monitor R or the like installed outside. 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 within 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, when the tube portion 54 of the colonoscope 51 is pushed into the sigmoid colon 72 in FIG. 7 (mouth), the sigmoid colon 72 is pushed upward as shown in FIG. As the curved part (A) curves upward, the curved part (A) becomes more acute, and it is very difficult to pass through this curved part (A). Even when the transverse colon 73 is bent downward due to the pushing force as shown in Figure 7 (e), the curved portion
It became more armored and 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, and it is an object of the present invention to provide a colonoscope that can be easily inserted into the large intestine. The purpose and gist of the colonoscope is to provide a colonoscope having at least an objective lens for observing the large intestine, an operating means that can adjust the direction of the tip, and a flexible tube part that can be inserted into the large intestine. At the tip of the tube of the colonoscope, a plurality of sensors capable of sensing the state of contact between the tip of the tube and the inner wall of the large intestine is installed, and the sensor receives a sensing signal from the sensor to detect the tip of the tube. A control means for determining the bending direction and controlling the operation means is configured in conjunction with each other.

(Function) Multiple sensors are installed at the tip of the tube of the colonoscope, and these sensors can detect the state of contact between the tip of the tube and the inner wall of the large intestine. control means are connected to each other, and when a sensing signal from the sensor is transmitted to this control means, the control means sends an instruction to bend the tip of the tube in a direction to avoid contact between the tip of the tube and the inner wall of the large intestine. and an operating means composed of a motor or the like, and the operating means is capable of guiding the tip of the tube along the curvature of the large intestine while bending the tip of the tube and avoiding contact between the tip of the tube and the inner wall of the large intestine. Therefore, the tip of the tube can easily pass between the walls of the large intestine during insertion, making the insertion operation easier.

(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, etc. 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 easily feeding air or water into the large intestine, a suction forceps port 61 for suctioning feces, etc. in the large intestine, and inserting forceps, etc., and a light lens for illuminating the large intestine. 57a are arranged, and these are similar to the conventional one. Furthermore, in this example, four pressure sensors Ca, Cb, Cc, and Cd are arranged at the tip of the tube portion 1a along with the objective lens 59 and the like. These four pressure sensors Ca, Cb, Cc
, Cd are arranged at 90° intervals on the circumferential surface of the tip of the tube portion 1a, the pressure sensor Ca can sense the upward pressure, the pressure sensor Cc can sense the downward pressure, and the pressure sensor cb can sense the downward pressure. Can sense the pressure on the right side, pressure sensor Cd
is arranged so that it can sense pressure on the left side. Each of the pressure sensors Ca, Cb, Cc, and Cd is covered with a flexible thin film-like film 3, and each film 3 is formed in the shape of a bag projecting outward.
A liquid 4 is sealed inside. Therefore, when each membrane 3 comes into contact with the inner wall of the large intestine, this membrane 3 is pushed 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. Ru.

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 curved 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 an appropriate length along the longitudinal direction from the tip of the tube portion 1a.The details are shown in Fig. 2. .

That is, to explain the propulsion section Sa located above the pipework in Fig. 2 as an example, the propulsion section Sa has wavy outer skins N, N, etc. formed in a wave shape in the longitudinal direction of the pipe section 1a. A bag-shaped inner bag portion FIT Fl, FS, Fa, FS, Fa provided inside each of the continuous wavy outer skins N I, N 2 . . . and each inner bag portion FI+ Fz, Fl, Liquid feed pipe E that can supply pressure liquid into Fa, Fa, and F- respectively! I E 21
The wavy outer skins N+, Nz... are formed of a flexible thin film material, and the wavy outer skins Nl, N! . . . A large number of rearwardly inclined folds 6 are implanted on the outer surface. This large number of propulsion folds 6 has a wavy outer skin N, , N2
... falls toward the wavy outer skin N, , N, . It has been configured to do so.

On the other hand, six inner bags FIT Fl, Fs, F4+ F6+ Fs are arranged inside each wavy outer skin N+, N*... The inner bag part F at the center is formed into a tall bag shape that protrudes most outwardly, and the inner bag parts F, , F, which are lower in height are arranged on both sides of this F. F, .

By supplying pressure liquid into each inner bag portion FI+ Ft, Fs, Fa, Fs, Fl, each inner bag portion F1+ F
t+ Fs, F4+ F5+ Fs can expand to cause the wavy skins N, , N, . . . to bulge outward.

Each liquid feed pipe E, , E, , E31 for supplying pressure liquid into the inner bag portion FIT Fl, Fs, Fa, FS, F-
E41 E6 + E8 are each piped in the outer skin part 55 along the longitudinal direction of the pipe part 1a, and each wavy outer skin N
Corresponding inner bag portions F in l, N2...
il F! , Fs, Fa, Fs, and Fa have a branched piping structure that can simultaneously supply pressure liquid into them. At the other end of each liquid feed pipe E + E1 + E3 + E4 + EatE6, there is a plunger pump P1 + P z
r P s + P 4+ P s y P s are connected, and each plunger pump P,, P,, P,
,P, ,Pl,P, are activated, respectively.
Each liquid feed pipe E+, El, Es, E4. Pressure liquid is either exhausted or sucked into Es. Therefore, this pair of plunger pumps P, , P, , P, , P, , Pl
.
P4y Pl, P is external microcomputer-7
It is connected to and its operation is controlled. That is,
Six plunger pumps P l + P 2 + P 3 that constitute a pair of injection suction pumps P! P4
rp6. The plunger pumps P6 are set to be operated sequentially from the plunger pumps P to Pl at constant timing intervals, and the inner bag portions FiIF2. Pressure liquid is sequentially supplied into the inner bag portion F1 + F l
The structure is such that r F 3 inflates sequentially from the front, and when the inner bag part F is fully inflated, the inner bag parts F I, F
2. It is programmed so that pressure fluid is sequentially extracted from Fs. Therefore, each inner bag portion Fl, Fx, F
3. By sequentially expanding and contracting FA, Fs, and Fa,
Each wavy skin N1. Nt... repeats expansion and contraction so that the waves move sequentially from the front to the rear.

At that time, a large number of propulsion folds 6 provided on the wavy outer skins N+, Nz, etc. stand up and come into contact with the large intestine wall 70, causing the tube portion 1a of the endoscope to advance forward. Can be done. Also, when curving inside the large intestine wall 70, the pressure of the 1 m infusion suction pump P is reduced,
The pressure of the injection suction pump P on the opposite side is programmed to be increased, ensuring ease of propulsion during curves.

FIG. 3 shows the state when curving inside the curved portion 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 this pressure signal, the microcomputer 7 drives the motor M, which pulls the wire Wa disposed on the pressure sensor Ca side, and vice versa.
(The wire Wc of Jtll is loosened. Therefore, the tip of the tube portion 1a of the endoscope is bent to the right. Corresponding to the bent state, the hydraulic pressure of the propulsion portion Sa is weakened, and conversely, the tip of the tube portion 1a of the endoscope 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, and an objective lens 59 and a CCD 64 for converting an image from the objective lens 59 into an electric signal are provided. A microcomputer 7 is connected to the pressure sensors Ca, Cb, Cc, and Cd, and each wire Wa, Wb, Wc, and Wd is connected to the microcomputer 7.
Two operating motors M are connected to the microcomputer 7 to operate the liquid feed pipes E, , E.
,, E31 E 4 * E 6+ Plunger pump P for supplying pressure fluid to E 6,, P! ,Ps,
Four pairs of injection/suction pumps P configured by P, , Pst P, are connected. Also, microcomputer
7 is connected so that it can also control an intake water pump U similar to the conventional one. In addition, a light guide power source K similar to the conventional one is connected to the colonoscope 1, and a rotating filter 63 is provided on this light guide power source K to pass red, blue, and green light to the colonoscope 1. It can be supplied to

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 and a video R stop can be connected to this image processing device 65. It is said to have a structure.

Microcomputer-7 is a well-known microcomputer, and basically consists of CPU7a and RAM7b.
, ROM7c, a program to control the CPU7a is written in the ROM7c, and the CPU7a controls the pressure sensor C according to this program.
a, Cb, Cc, and Cd, or performs arithmetic processing while exchanging data with the RAM 7b, and outputs the processed data to the operation motor M and the injection/suction pump P as necessary. It is something.

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 pressure is detected by all pressure sensors Ca, Cb, Cc, and Cd (step 2). If it is determined that no pressure is felt by any pressure sensor,
An operating signal is generated and output from the microcomputer 7 to the propulsion injection suction pump P, and a free position operating signal is generated to the operating motor M to set each wire Wa, Wb, We, and Wd in a free state. Output (
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 each liquid feed pipe E1. Et, E
Pressure liquid is sequentially fed to sr E4+ Esr Es and suctioned sequentially to cause the wavy outer skins Nl, Nt, . . . to rise in a wavy manner from the front to the rear (step 4). 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 has been 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 The wire operation motor M is moved in the direction of loosening the wire on the side of the detected pressure sensor and pulling the wire on the opposite position side.
Generates and outputs an operating signal to rotate. At the same time, each propulsion plunger pump PI, P! on the sensor side that detected the pressure for the injection suction pump P! , Ps, . . . and decreases the output of each plunger pump P, , P, , P, . The wire operation motor M and the injection/suction pump P are operated according to these operation signals (step 8). That is, for example, when pressure is felt at the lower pressure sensor Cc, the operating motor M is moved in the direction of loosening the wire We and pulling the wire Wa.
is rotated, and the injection suction pump P is operated so as to increase the hydraulic pressure supplied to the lower propulsion section Sc and decrease the hydraulic pressure supplied to the upper propulsion section Sa. 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 is performed according to a loop 2 program described later. When the operating force of the wire operation motor M is less than 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 10). After this forward movement, any pressure sensor Ca
When pressure signals are detected from , Cb, Cc, and Cd,
Similarly to the above, steps 6, 7, and 8 are sequentially performed, and the tip of the tube portion 1a moves forward while being bent in an appropriate direction.
, the progression in step 8 is read quickly within a predetermined time, and it is determined whether or not the same pattern has been repeated a predetermined number of times (step 11), and when the same pattern has been repeated a predetermined number of times or more, loop 3, which will be described later, is performed. Processed by the program.

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, and the forward and backward movements are performed alternately so that the tip of the tube portion 1a touches the colon wall. 70 and will gradually move forward.

Next, in loop 2 shown in FIG.
In this case, the tip of the infusion suction pump P is bent too much and gets stuck in the intestinal wall.
FF, and the liquid in each liquid feed pipe E,, E,, E,, E,... is sent to each plunger pump P+, Pt, Ps...
will be collected within.

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 time has elapsed (step 15), the injection suction pump P for propulsion is completely turned off, and the pressure fluid is supplied to each plan. jar pump P+,
Px, Ps..., each wire Wa,
Wb yWC! Wd is completely freed (step 16). In this state, a delta alarm constituted by an external LED or buzzer is activated (step 17). In this state, the tip of the tube portion 1a is quite firmly caught on the wall surface of the large intestine wall 70. Therefore, the doctor often needs to turn the switch OFF and remove the colonoscope 1 from the colon.

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. In this case, for example, the tip of the tube portion 1a is located in a bag/J% within the large intestine wall 70.
A possible case is when the vehicle hits a road. 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. A command signal is output to the motor M and simultaneously increases the output of the propulsion injection suction pump P on the sensor side shifted in the 90'' direction, and decreases the output of the injection suction pump P on the opposite position side. is output to the pump P (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, if the tip of the tube portion 1a is When a dead end is reached in the large intestine wall 70, for example, the pressure sensor Ca and the pressure sensor Cc located on the opposite side thereof come into contact with the large intestine wall 70, and the distal end of the tube portion 1a can no longer move in the vertical direction. In that case, it may be possible to escape from the dead end, by loosening the wires Wb located in the left and right direction and pulling the wires Wd on the opposite side. The propulsive force of the tube section 1a 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 forward movement is repeated again according to the main program by the loop 1 (step 20).However, Similarly, in the left and right state, when the same pattern is repeated many times within a predetermined period of time (step 21), the injection suction pump P for propulsion is turned off, and each of the liquid feed pipes E,.

The liquid in El, Es, E, . . . is collected into each plunger pump P+, Pg, Ps, . Further, the wire operation motor M is rotated to the wire free position, and each wire Wa, Wb, Wc, Wd is set in a free state (step 22).In other words, in this state, the left and right directions are also in a dead end state, and the wires are no longer connected. Part 1
The tip of point a is now in a state where it is impossible to move forward in any 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 24). ). However, after a certain period of time has elapsed, if the curve continues to be repeated in the same way, it is no longer possible to move forward.
After this determination is made (step 25), the propulsion injection suction pump P is completely turned off, and the pressure fluid is collected into each plunger pump P, pg, Ps, . . . . Furthermore, the operating motor M is placed in a wire free state (step 26). At this time, the external LED
Alternatively, an alarm is issued by a buzzer or the like (step 27).

Next, loop 4 is shown in Figure 5 (d) as an emergency program.
shows.

That is, each pressure sensor Ca, Cb, Cc,
When a pressure above a certain level is felt in Cd, or when a pressure above a certain level is felt in all pressure sensors Ca, Cb, Cc, and Cd (step 28), the injection suction pump P is turned off and the propulsion pump is turned off. Pressure fluid is supplied to each plunger pump P1. P2. P3..., and the wire operation motor M is placed in the wire free state (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, a warning signal is emitted from the external LED or buzzer (
Step 36). There are also times when the switch is turned off (step 34).

Further, steps 33 and 34 are also 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 is constantly 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 this example, four pressure sensors Ca, Cb, Cc, and Cd are disposed at the tip of the pipe portion 1a, but three
It is also possible to arrange 1 to 13 pieces, and the number is not limited.

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

Furthermore, each of the wavy outer skins N r , N z , . Bag-shaped inner bag portion FI+ F*, F3. F4. F6. It can also be formed integrally with F6.

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.
Although a structure is shown in which the rotary filter 63 is not used, a structure using three color light receiving elements CCD that can convert each of the red, blue, and green signals into electrical signals may also be used. can. In that case, the light guide power source allows white light to be projected into the colon from the tip lens through the relight guide glass fiber, and when this light is projected onto the polyp Te9 in the colon, it passes through the objective lens to 3
An image of the polyp T is captured by a pair of individual CCDs, 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.

Further, 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. Therefore, when the temperature sensor is replaced with a pressure sensor, the structure is such that air that is lower than body temperature is blown out near the temperature sensor, and when the low-temperature air comes into contact with the lining of the colon, the low-temperature air is released into the lining of the colon. is heated and sensed by a temperature sensor, making it 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 a program to operate the air and water pump U at appropriate times into the control program in this example, and by operating the air and water pump U, the large J wall 70 can be supplied with air or water. This allows the tube portion 1a to be expanded to improve the progress of the tip of the tube portion 1a.

(Effects of the Invention) The colonoscope of the present invention has at least an objective lens for observing the large intestine and an operating means that can adjust the direction of the distal end, and has a flexible tube part that can be inserted into the large intestine. ; a colonoscope with a first design; the tip of the tube of the colonoscope is provided with a plurality of sensors for sensing the state of contact between the tip of the tube and the inner wall of the large intestine; and a control means that determines the bending direction of the tip of the tube in response to a sensing signal from the sensor and controls the operation means (this allows the sensor to effectively sense the state of contact with the inner wall of the large intestine). Since the direction of movement of the tip of the tube is controlled by the control means according to the sensing signal of this sensor, 1. The tip of the endoscope can be smoothly advanced into the colon, and the No skill is required to insert the speculum, and it also has the effect of eliminating patient pain 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 COD. 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, S
c, 5cl-propulsion part N = , N!・・・・・・
・Wavy outer skin F,,F,,F,,F,,F,,F,...
Inner bag portion E1. E! , E-, E-, Es, Ee...Liquid feed pipe P1. Pi, Ps, Pt, Pa, Ps... Plunger pump 55... Outer skin part 59... Objective lens 60a... Air/water supply nozzle 61... Suction, Vibro 4 for forceps... CCD Patent Applicant NoJ-Eiji Hayashi 4-figure demi, BJ Eri j set! Figure 7 (-a) (shi) (,r,)

Claims (2)

[Claims] (1) A colonoscope that has at least an objective lens for observing the large intestine and an operating means that can adjust the tip direction, and a flexible tube that can be inserted into the large intestine. A plurality of sensors are installed at the tip of the tube of the endoscope to detect the state of contact between the tip of the tube and the inner wall of the large intestine, and the sensor receives a sensing signal from the sensor to determine the bending direction of the tip of the tube. and a colonoscope connected to a control means for controlling the operation means. (2) Claim 1, in which the sensor is a pressure sensor and the control means is a microcomputer.
Colonoscopy as described in section.