JPWO2020100844A1 - Lacrimal duct endoscopy - Google Patents

Abstract

The lacrimal duct endoscope (10) includes a tubular insertion portion (100) to be inserted into the lacrimal passage and a base portion (200) to which the proximal end (100a) of the insertion portion (100) is attached. The lacrimal duct endoscope (10) includes a first curved portion (140) bent in the first direction and a second curved portion (150) bent in the second direction opposite to the first direction. The first curved portion (140) is formed on the insertion portion (100) or the base portion (200), and the second curved portion (150) is the tip (100b) of the insertion portion (100) rather than the first curved portion (140). ) Is formed on the side.

Description

The present invention relates to a lacrimal duct endoscope.

A lacrimal duct endoscope is known as a rigid lacrimal duct speculum used for observation, diagnosis, imaging, or treatment of the lacrimal duct lumen. The lacrimal duct endoscope includes a rigid insertion portion to be inserted into the lacrimal passage, and an optical fiber tube bundle, a channel for water passage, and the like are provided in the tubular insertion portion.

The base end of the insertion portion is attached to the base portion (body) gripped by the user of the lacrimal duct endoscope.

Further, such an insertion portion of the lacrimal duct endoscope generally has a partially curved shape in order to facilitate insertion into the lacrimal duct (see Patent Document 1).

Japanese Patent No. 6180449

However, the conventional lacrimal duct endoscope described above has the following problems. Specifically, when the insertion site is inserted into the lacrimal passage, the base may interfere with the upper part of the patient's orbit and the insertion site may not be properly inserted into the lacrimal passage.

Specifically, it has been confirmed that the base hits the edge of the patient's orbit (around the eyebrows) and the insertion part cannot be inserted into the lacrimal passage. In particular, such a phenomenon is likely to occur in patients with deeply carved or dark eyes.

In addition, even in the case of a patient whose nasolacrimal duct passes closer to the skull, the base hits the edge of the patient's orbit, and the insertion part cannot be inserted into the lacrimal duct or the same operation as in a patient who does not have a deep eye. Has been confirmed.

Therefore, the present invention has been made in view of such a situation, and an object of the present invention is to provide a lacrimal duct endoscope capable of appropriately inserting the insertion portion into the lacrimal duct without the base interfering with the upper part of the orbit of the patient. And.

The lacrimal duct endoscope according to the embodiment of the present invention includes a tubular insertion portion to be inserted into the lacrimal passage and a base portion to which the base end of the insertion portion is attached. The lacrimal duct endoscope includes a first curved portion bent in the first direction and a second curved portion bent in the second direction opposite to the first direction. The first curved portion is formed at the insertion portion or the base portion. The second curved portion is formed on the tip end side of the insertion portion with respect to the first curved portion.

The lacrimal duct endoscope according to the above configuration includes a first curved portion bent in the first direction and a second curved portion bent in the direction opposite to the first direction. Therefore, even in a patient with deep or deep carving, the insertion portion can be appropriately inserted into the lacrimal passage without interfering with the base portion of the patient's upper orbit.

FIG. 1 is a perspective view of the lacrimal duct endoscope 10 according to the embodiment. FIG. 2 is a side view of the lacrimal duct endoscope 10 according to the embodiment. FIG. 3A is a view showing the tip 100b surface of the insertion portion 100 of the lacrimal duct endoscope 10 according to the embodiment, and FIG. 3B is a view when the tearway endoscope 10 is cut along the line IIIb-IIIb in FIG. It is an enlarged cross-sectional view. FIG. 4 is an enlarged view of a main part in the side view of the lacrimal duct endoscope 10 according to the embodiment. FIG. 5 is a diagram showing a state in which the lacrimal duct endoscope 10 according to the embodiment is inserted into the lacrimal duct. FIG. 6 is a side view of the lacrimal duct endoscope 10 according to another embodiment.

Hereinafter, embodiments will be described with reference to the drawings. The same functions and configurations are designated by the same or similar reference numerals, and the description thereof will be omitted as appropriate.

(1) Overall Schematic Configuration of Lacrimal tract Endoscope FIG. 1 is a perspective view of the lacrimal duct endoscope 10 according to the embodiment of the present invention. FIG. 2 is a side view thereof.

As shown in FIGS. 1 and 2, the lacrimal duct endoscope 10 includes a tubular insertion portion 100 to be inserted into the lacrimal passage and a base portion 200 to which the base end 100a of the insertion portion 100 is attached.

FIG. 3 (a) is a view of the tip surface of the tip 100b of the insertion portion 100 as viewed from a vertical direction, and FIG. 3 (b) shows the insertion portion 100 as an outer tube along the line IIIb-IIIb in FIG. It is an enlarged cross-sectional view when cut perpendicular to the central axis of 300.

The lacrimal duct endoscope 10 includes a rigid insertion portion 100. As shown in FIGS. 3A and 3B, the insertion portion 100 is covered with an outer tube 300 that covers the outer peripheral surface. The outer pipe 300 is made of a metal such as stainless steel. However, as the material of the outer tube 300, a hard plastic, a metal, or a composite material thereof may be used.

In the tubular insertion portion 100, an objective lens 310, an optical fiber tube bundle 320, 330, and a channel 340 for ventilation and / or water passage are provided as an observation window at the time of photographing. The optical fiber tube bundles 320 and 330 include an image guide fiber 320 that transmits the captured image to an imaging system (not shown) and a light guide fiber 330 that conducts light from a light source (not shown) to illuminate the imaged object. including. The ventilation and / or water flow channel 340 is used to ventilate the lacrimal passage or to pass physiological saline or the like as necessary when inserting the lacrimal duct endoscope 10 or when photographing the inside. Channel.

As shown in FIG. 2, the base 200 includes a support portion 210, a grip portion 220, and a connection portion 230. The base 200 is a metal housing (body), and the optical fiber tube bundles 320 and 330 and channels 340 for ventilation and / or water flow are housed inside the base 200.

Stainless steel (SUS) is preferably used as the housing constituting the base 200, but other relatively hard plastics, metals, or composite materials thereof may be used.

As shown in FIG. 1, the grip portion 220 has a cylindrical shape. Specifically, the grip portion 220 has a substantially cylindrical shape. The grip portion 220 is a portion that is gripped by the user's hand when operating the lacrimal duct endoscope 10. The central axis CL of the grip portion 220 extends parallel to the longitudinal direction of the base 200. In the present specification, the central axis of the base 200 means the central axis CL of the grip portion 220. In the present embodiment, the grip portion 220 has a substantially cylindrical shape, but the grip portion 220 is not limited to this as long as it has a cylindrical shape. For example, the grip portion 220 may have a polygonal columnar shape, a truncated cone shape, or the like.

The support portion 210 is connected to the base end 100a of the insertion portion 100 at one end in the longitudinal direction of the base portion 200. The support portion 210 is connected to the grip portion 220 at the other end of the base portion 200 in the longitudinal direction. The support portion 210 has a tapered shape in which the outer diameter decreases with a constant gradient from the grip portion 220 side to the insertion portion 100 side in the longitudinal direction of the base portion 200. An end face 210b perpendicular to the longitudinal direction of the base 200 is formed at the end of the insertion portion 100 that is connected to the base end 100a. The support portion 210 coaxially supports the first straight line portion 110 (see FIG. 4) of the insertion portion 100.

The connecting portion 230 is connected to the grip portion 220 and has a width wider than the grip portion 220 along the direction orthogonal to the central axis CL so that the lure port 240 for ventilation and / or the water passage and the Unicode portion 250 can be connected. Is.

The ventilation and / or water passage lure port 240 is a connection port for supplying air from a supply source, physiological saline, or the like to the ventilation and / or water passage channel 340 of the insertion portion 100.

The Unicode portion 250 includes an optical fiber tube bundle 320, 330 extending from the insertion portion 100, and covers the optical fiber tube bundle 320, 330. The Unicode unit 250 is connected to the imaging system light source.

(2) Shape of Insertion Part FIG. 4 is an enlarged view of a main part showing details of the insertion part 100 in the side view of the lacrimal duct endoscope 10 according to the present embodiment.

As shown in FIG. 4, the insertion portion 100 includes a first straight line portion 110 extending vertically from the end surface 210b of the support portion 210, a second straight line portion 120 located at the tip of the insertion portion 100, and a first straight line portion 110. A curved portion 130 formed between the second straight portion 120 and the curved portion 130 is included. In this embodiment, the total length of the insertion portion 100 is set to about 60 mm.

The first straight line portion 110 is connected to the end surface 210b of the support portion 210 and extends along the central axis CL of the grip portion 220. One end of the curved portion 130 is connected to the first straight line portion 110 in the longitudinal direction of the base portion 200, and the other end of the curved portion 130 located on the tip 100b side of the insertion portion 100 is connected to the second straight line portion 120.

The curved portion 130 is a first curved portion 140 bent in the first direction perpendicular to the longitudinal direction of the base 200 with respect to the central axis CL of the grip portion 220, and the curved portion 130 is bent in the second direction opposite to the first direction. Also includes a second curved portion 150. In the present embodiment, the second curved portion 150 is formed on the tip 100b side of the insertion portion 100 with respect to the first curved portion 140.

In the present embodiment, when the first curved portion 140 and the second curved portion 150 are bent, the optical fiber tube bundles 320 and 330 provided in the insertion portion 100 and the channels 340 for ventilation and / or water flow are formed. It is curved and extends toward the tip 100b of the insertion portion 100.

In the present embodiment, the center of curvature P1 of the first curved portion 140 is located on the side in the first direction perpendicular to the central axis CL of the gripped portion 220 with respect to the central axis CL of the gripped portion 220. Specifically, the first curved portion 140 has an arc shape with a radius of curvature R1 of 30 mm, and is curved in the first direction from the central axis CL of the gripped portion 220.

In the present embodiment, the centers of curvature P2 and P3 of the second curved portion 150 are located on the side in the second direction opposite to the first direction with respect to the insertion portion 100. Specifically, the second direction is the direction of the Unicode portion 250 with respect to the central axis CL of the grip portion 220. The second curved portion 150 includes a small curved region 170 having a predetermined radius of curvature R2 at the center of curvature P2 and a large curved region 160 having a radius of curvature R3 smaller than the predetermined radius of curvature R2 at the center of curvature P3. Specifically, the small curved region 170 has an arc shape with a radius of curvature R2 of 140 mm, and the large curved region 160 has an arc shape with a radius of curvature R3 of 44 mm. The large curved region 160 is formed on the tip 100b side of the insertion portion 100 with respect to the small curved region 170. The end portion of the second curved portion 150 connected to the second straight line portion 120 is bent in the second direction with respect to the longitudinal direction of the base portion 200.

The radius of curvature R1 of the first curved portion 140 is smaller than the radius of curvature R2 and R3 of the curved regions 170 and 160 in the second curved portion.

(3) Action / Effect FIG. 5 is a diagram showing a state in which the lacrimal duct endoscope 10 is inserted into the lacrimal duct. Specifically, FIG. 5 shows a state in which the insertion portion 100 is inserted into the nasal lacrimal duct from the fossa for lacrimal fossa FLS.

In the present embodiment, the insertion portion 100 has a shape including a first curved portion 140 bent in the first direction and a second curved portion 150 bent in the opposite direction to the first direction. According to the shape of the insertion portion 100, even when the lacrimal duct endoscope 10 is operated with the insertion portion 100 inserted into the nasolacrimal duct, the insertion portion 100 and the base 200 interfere with the frontal bone FB. It becomes difficult. As a result, it is possible for the patient with the back eye to perform the same operation as the patient with the back eye, which is not affected by the position through which the nasolacrimal duct passes.

In the present embodiment, the bending direction of the second curved portion 150 is the direction of the Unicode portion 250 with respect to the central axis CL of the grip portion 220. Therefore, even when the insertion portion 100 is inserted into the nasolacrimal duct, the unicord portion 250 is less likely to interfere with the frontal bone FB.

Further, in the present embodiment, when the insertion portion 100 is inserted into the nasolacrimal duct, the longitudinal direction of the base portion 200 is an angle close to the insertion direction of the insertion portion 100. Therefore, the operability of the lacrimal duct endoscope 10 is improved, and the insertion operation of the lacrimal duct endoscope 10 can be easily performed. Further, it is possible to suppress the deformation of the insertion portion 100 due to the excessive force applied to the lacrimal duct endoscope 10 during the insertion operation.

In the configuration of the present embodiment, the insertion portion 100 cannot be inserted into the lacrimal duct because the base 200 hits the edge of the patient's orbit, that is, the area around the eyebrows, especially in a patient with deep carving or a nasolacrimal duct. It is more effective when it is difficult to guide the insertion portion 100 into the nasolacrimal duct.

In the present embodiment, the radius of curvature R1 of the first curved portion 140 is smaller than the radius of curvature R2 and R3 of the second curved portion 150. Therefore, the insertion portion 100 and the base portion 200 are less likely to interfere with the frontal bone FB.

In the present embodiment, the large curved region 160 is formed on the tip 100b side of the insertion portion 100 with respect to the small curved region 170. Therefore, when the lacrimal duct endoscope 10 is inserted into the lacrimal duct, the insertion portion 100 into the nasolacrimal duct can be easily guided through the lacrimal canaliculi bent from the lacrimal punctum.

In the present embodiment, the tip 100b of the insertion portion 100 is located on the first direction side of the central axis CL of the grip portion 220 in the base portion 200. Therefore, in the operation of inserting the insertion portion 100 into the lacrimal passage, the base portion 200 is less likely to interfere with the frontal bone FB.

(4) Other Embodiments Although the contents of the present invention have been described above with reference to the examples, the present invention is not limited to these descriptions, and various modifications and improvements are possible. It is self-evident to the trader.

For example, in the above embodiment, the first curved portion 140 is formed so as to be connected to the first straight portion 110 of the insertion portion 100. However, the arrangement of the first curved portion 140 is not limited to this.

Further, in the above embodiment, the shape of the support portion 210 is a taper shape in which the outer diameter is reduced with a constant gradient from the grip portion 220 side to the insertion portion 100 side in the longitudinal direction of the base portion 200. However, the shape of the support portion 210 is not limited to this. For example, it may be a columnar shape extending from the grip portion 220 side to the insertion portion 100 side with a constant outer shape.

FIG. 6 is a modified example showing the lacrimal duct endoscope 10A in which the first curved portion 140A is formed on the base portion 200A. In the modified example, the support portion 210A is bent in the first direction from the central axis of the base portion 200A (the central axis CL of the grip portion 220). The optical fiber tube bundles 320 and 330 of the first curved portion 140A and the channels 340 for ventilation and / or water flow are located in the base portion 200A (support portion 210A), similarly to the first curved portion 140 of the above embodiment. It is bent in one direction. However, in the first curved portion 140A, the base portion 200A may be bent in the first direction, and the optical fiber tube bundles 320 and 330 passing through the inside and the channels 340 for ventilation and / or water passage are arranged in a straight line. You may. The base portion 200A is formed so that the end surface 210Ab of the support portion 210A forms a predetermined angle with the central axis CL of the grip portion 220. The insertion portion 100A extends substantially vertically from the center of the end surface 210Ab of the support portion 210A, and is connected to the second curved portion 150 on the tip end side.

Since at least a part of the first curved portion 140A is protected by the supporting portion 210A, according to the lacrimal duct endoscope 10A according to the modified example, even when the lacrimal duct endoscope 10A is loaded, the first curved portion 140A Plastic deformation is suppressed and the curved shape is maintained.

Although embodiments of the invention have been described above, the statements and drawings that form part of this disclosure should not be understood to limit the invention. Various alternative embodiments, examples and operational techniques will be apparent to those skilled in the art from this disclosure.

The entire contents of Japanese Patent Application No. 2018-215006 (Filing date: November 15, 2018) are incorporated herein by reference.

10,10A Lacrimal sac endoscopy 100,100A Insertion part 100a Base end 100b Tip 110 First straight part 120 Second straight part 130 Curved part 140, 140A First curved part 150 Second curved part 160 Large curved area 170 Small curved area 200, 200A Base 210, 210A Support 220 Grip 230 Connection 240 Ventilation and / or water flow Luer port 250 Unicord 300 Exterior tube 310 Objective lens 320 Image guide fiber 330 Light guide fiber 340 Channel CL Center axis FLS Tears Fossa for lacrimal FB frontal bone

Claims (6)

A lacrimal duct endoscope comprising a tubular insertion portion to be inserted into the lacrimal passage and a base to which the proximal end of the insertion portion is attached.
The first curved part bent in the first direction and
Including a second curved portion bent in the second direction opposite to the first direction.
The first curved portion is formed on the insertion portion or the base portion, and is formed on the insertion portion or the base portion.
The second curved portion is a lacrimal duct endoscope formed on the distal end side of the insertion portion with respect to the first curved portion. Unicode is connected to the base
The lacrimal duct endoscope according to claim 1, wherein the second direction is the direction of Unicode with respect to the central axis of the base. The lacrimal duct endoscope according to claim 1 or 2, wherein the radius of curvature of the first curved portion is smaller than the radius of curvature of the second curved portion. The second curved portion is
A small curvature region with a predetermined radius of curvature and
Including a large curvature region having a radius of curvature smaller than the predetermined radius of curvature.
The lacrimal duct endoscope according to any one of claims 1 to 3, wherein the large curved region is formed on the distal end side of the insertion portion with respect to the small curved region. The lacrimal duct endoscope according to any one of claims 1 to 4, wherein the tip of the insertion portion is located on the first direction side of the central axis of the base portion. The first curved portion is formed on the proximal end side of the insertion portion.
The lacrimal duct endoscope according to any one of claims 1 to 5, wherein a straight line portion is formed between the first curved portion and the base portion.

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