KR20160075186A

KR20160075186A - Endoscope System And Method of Operating The Same

Info

Publication number: KR20160075186A
Application number: KR1020140184859A
Authority: KR
Inventors: 김용욱
Original assignee: 연세대학교 산학협력단
Priority date: 2014-12-19
Filing date: 2014-12-19
Publication date: 2016-06-29

Abstract

The endoscopic system includes a surgical endoscope, an endoscope guide tube, a pocket, a fluid delivery tube, and a fluid inlet. The surgical endoscope includes a camera for generating a video signal. The endoscope guide tube is connected to the endoscope at one end and inserted into the inside of the object, and the other end is disposed outside the subject, and guides the endoscope to the inside of the object. The pockets are disposed in the periphery of the endoscope and expand / contract according to infusion / discharge of fluid. And is disposed along the endoscope guiding tube and connected to the pocket to inject / discharge the fluid. The fluid injection port is connected to the fluid transfer tube and disposed outside the object to inject / discharge the fluid into the fluid transfer tube.

Description

TECHNICAL FIELD [0001] The present invention relates to an endoscope system,

The present invention is to provide an endoscopic system. And more particularly, to an endoscope system and a method of driving the endoscope system that are easy to secure a treatment space and a field of view.

Techniques for inspecting the internal state of the body without losing it have a long history. Recently, various technologies such as X-ray, MRI, and CT have been developed due to the development of electronic technology. However, the above technologies are technologies for diagnosing the inside of the body by converting electromagnetic phenomena indirectly into images, and the accuracy is lower than that of observing directly by visual observation.

Endoscopic techniques have been developed to create a visual image directly by inserting an elongated instrument into the body cavity. Endoscopy is widely used because of its ability to directly observe the state in the body cavity.

Because of the advantage that the endoscope can be inserted into the body cavity without losing it, a technique has been developed for diagnosing the body cavity and performing the procedure simultaneously by attaching a surgical instrument to the endoscope.

However, unlike laparotomy, it is difficult to obtain an arbitrary treatment space when performing the operation in the body cavity. In addition, there arises a problem that the visual field of the endoscope is blurred due to bleeding occurring during the procedure.

SUMMARY OF THE INVENTION It is an object of the present invention to provide an endoscope system that is easy to secure a treatment space and a visual field.

It is another object of the present invention to provide a method of driving an endoscope system as described above.

In order to solve the above problems, the endoscope system of the present invention includes a surgical endoscope, an endoscope guide tube, a pocket, a fluid delivery tube, and a fluid inlet. The surgical endoscope includes a camera for generating a video signal. The endoscope guide tube is connected to the endoscope at one end and inserted into the inside of the object, and the other end is disposed outside the subject, and guides the endoscope to the inside of the object. The pockets are disposed in the periphery of the endoscope and expand / contract according to infusion / discharge of fluid. And is disposed along the endoscope guiding tube and connected to the pocket to inject / discharge the fluid. The fluid injection port is connected to the fluid transfer tube and disposed outside the object to inject / discharge the fluid into the fluid transfer tube.

In one embodiment, the pocket may comprise a transparent material.

In one embodiment, the pockets may further include a plurality of the fluid transfer tubes and the plurality of fluid inlets corresponding to the plurality of pockets, the plurality of pockets being disposed along the periphery of the endoscope.

In one embodiment, the pockets can be inflated / deflated independently.

In order to solve the above problems, the present invention provides an endoscopic system comprising: a surgical endoscope including a camera for generating an image signal and a surgical tool for working inside the object; An endoscope guiding tube connected to the endoscope at one end and inserted into the inside of the object, the other end being disposed outside the object, and guiding the endoscope to the inside of the object; A plurality of pockets disposed in the periphery of the endoscope and expanding / retracting in accordance with fluid injection / discharge; A plurality of fluid delivery tubes disposed along the endoscope guiding tube and connected to the pockets to inject / discharge the fluid; And a plurality of fluid inlets, respectively connected to the fluid transfer tubes and disposed outside the object, for injecting / discharging the fluid into / from the fluid transfer tubes. In the method of driving the endoscope system, first, the procedure endoscope and the pockets are inserted into an object. The fluids are then separately injected / discharged through the fluid injection ports to inflate / deflate the pockets individually. Thereafter, when the position of the treatment endoscope does not reach the treatment position, the step of separately injecting / discharging the fluid is repeated to reach the position of the treatment endoscope to the treatment position. Subsequently, when the position of the procedure endoscope reaches the procedure position, the procedure is performed inside the object using the procedure tool.

As described above, according to the present invention, the endoscope system includes the pockets disposed at the distal end thereof, so that it is easy to secure the view of the procedure endoscope and to secure the procedure space. In addition, since the fluid inside the pockets and the pockets is transparent, even if the pockets are disposed on the front surface of the endoscope, it is easy to secure a view. Pockets and fluids are harmless to humans, including biocompatible materials.

Moreover, it is possible to secure a better view by the hemostatic effect by the pressure by the pockets, and emergency hemostasis is possible in an unexpected situation.

Also, when injecting a fluid with low temperature, the heat generated by the endoscope is cooled to increase the operation time.

Furthermore, the fluid injection ports can be driven separately to individually control the amount of fluid injected into the pockets. Therefore, it is possible to arbitrarily change the treatment position by adjusting the position of the distal end portion.

Also, the pockets are fixed to the surrounding tissues and the position of the distal end is fixed. Therefore, it is possible to perform a stable operation with the distal end being stably fixed.

1 is a perspective view showing an endoscope system according to an embodiment of the present invention.
Fig. 2 is a front view showing the front end portion of Fig. 1;
3 is a perspective view showing a procedure endoscope of the endoscope system shown in Fig.
4 is a cross-sectional view taken along line I-I 'of FIG.
5 is a perspective view showing a state in which fluid is discharged from the endoscope system shown in FIG.
FIG. 6 is a perspective view showing a state in which only a part of fluid is discharged in the endoscope system shown in FIG. 1;

Before describing in detail several embodiments of the invention, it will be appreciated that the application is not limited to the details of construction and arrangement of components set forth in the following detailed description or illustrated in the drawings. The invention may be embodied and carried out in other embodiments and carried out in various ways. It should also be noted that the device or element orientation (e.g., "front," "back," "up," "down," "top," "bottom, Expressions and predicates used herein for terms such as "left," " right, "" lateral," and the like are used merely to simplify the description of the present invention, Or that the element has to have a particular orientation.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Reference will now be made in detail to the preferred embodiments of the present invention, examples of which are illustrated in the accompanying drawings. Prior to this, terms and words used in the present specification and claims should not be construed as limited to ordinary or dictionary terms, and the inventor should appropriately interpret the concepts of the terms appropriately It should be construed in accordance with the meaning and concept consistent with the technical idea of the present invention based on the principle that it can be defined.

Therefore, the embodiments described in this specification and the configurations shown in the drawings are merely the most preferred embodiments of the present invention and do not represent all the technical ideas of the present invention. Therefore, It is to be understood that equivalents and modifications are possible.

Fig. 1 is a perspective view showing an endoscope system according to an embodiment of the present invention, Fig. 2 is a front view showing a distal end portion of Fig. 1, Fig. 3 is a perspective view showing a procedure endoscope of the endoscope system shown in Fig. Is a cross-sectional view taken along line I-I 'of FIG.

1 to 4, an endoscope system includes a procedure endoscope 10, pockets 112, 114, and 116, an endoscope guide tube 120, and fluid inlets 132, 134, and 136.

The treatment endoscope 10 is disposed at the distal end of the endoscope system and includes a camera 12 and a treatment tool 14. [ At this time, the procedure endoscope 10 may further include a light source (not shown). A light source (not shown) provides light to the front end of the distal end so that the camera 12 can take an image smoothly. In another embodiment, the procedure endoscope 10 includes a camera 12 and a light source (not shown), and the procedure tool 14 may be omitted.

The camera 12 is disposed on the front surface of the front end portion, and changes the front surface image of the front end portion to a video signal.

The endoscope guiding tube 120 connects the inside and the outside of the endoscope and moves the procedure endoscope 10 and the pockets 112, 114, and 116 to the inside of the human body. Endoscopic guide tube 120 includes image transfer portion 20 and fluid delivery tubes 122, 124 and 126.

The image transmitting unit 20 is connected to the camera 12 and transmits the image taken by the camera 12 to the outside. For example, the image transmission unit 20 may include a transmission cable. In another embodiment, an optical lens (not shown) may be disposed instead of the camera 12, and an optical cable may be disposed instead of the image transmitting portion 20. [

The treatment tool 14 protrudes outside the distal end portion to perform operations such as surgery. The operation tool 14 can freely move in and out of the stepped portion. During the movement of the distal end portion into the body cavity, the treatment tool 14 is disposed in the distal end portion, and after positioning, protrudes outward from the distal end portion to perform a surgical operation. In the present embodiment, the procedure tool 14 includes a cutting mass, but the procedure tool 14 can be variously used without being limited to the type.

At least one of the pockets 112, 114, 116 is disposed at the distal end and is capable of contraction and expansion. When the pockets 112, 114, and 116 expand, the tissue around the distal end is pushed to secure the field of view of the camera 12 and the procedure space of the procedure tool 14.

The pockets 112,114 and 116 are connected to the fluid delivery tubes 122,124 and 126 of the endoscope guide tube 120 and are inflated by the inflow of fluid introduced through the fluid delivery tubes 122,124 and 126 .

The pockets 112, 114, and 116 have a resilient bag shape. In this embodiment, the pockets 112, 114, and 116 include a transparent synthetic resin or a transparent rubber.

Fluids injected into the pockets 112, 114, and 116 include air or physiological saline that is harmless to the human body. When the fluid to be injected into the pockets 112, 114 and 116 is air or physiological saline, even if the pockets 112, 114, and 116 are torn by the treatment tool 14 during the procedure, There is no.

The fluid is injected through an inlet 132, 134, 136 disposed at the opposite end of the endoscope system. Fluid injected through the inlets 132,134 and 136 is delivered to the pockets 112,114 and 116 through the fluid delivery tubes 122,124 and 126 to inflate the pockets 112,114 and 116.

5 is a perspective view showing a state in which fluid is discharged from the endoscope system shown in FIG.

1 to 5, when fluid is discharged from the pockets 112, 114, and 116 of the endoscope system, the pockets 112, 114, and 116 contract and contract to the distal end.

When the fluid injection ports 132, 134, 136 are depressurized, the fluid transmission tubes 122, 124, 126 and the pockets 112, 114, 116 connected to the fluid injection ports 132, 134, When the pockets 112, 114, and 116 are depressurized, the pockets 112, 114, and 116 contract due to the pressure inside the body, thereby reducing the volume.

In the present embodiment, the endoscope system includes a plurality of pockets 112, 114, 116 and a plurality of fluid inlets 132, 134, 136, And includes delivery tubes 122, 124, 126. For example, the endoscopic system may include a first pocket 112, a second pocket 114, a third pocket 116, a first fluid inlet 132, a second fluid inlet 134, and a third fluid inlet 136 124 includes a first fluid transfer tube 122, a second fluid transfer tube 124, and a third fluid transfer tube 126. The first fluid transfer tube 122, the second fluid transfer tube 124,

The first to third fluid transfer tubes 122, 124, 126 have a tube shape. For example, the first to third fluid transmission tubes 122, 124, and 126 may have various shapes of tubes such as cylinders, rectangles, and polygons.

The first pocket 112 is connected to one end of the first fluid delivery tube 122 and the first fluid injection port 132 is connected to the other end of the first fluid delivery tube 122. The second pocket 114 is connected to one end of the second fluid delivery tube 124 and the second fluid injection port 134 is connected to the other end of the second fluid delivery tube 124. The third pocket 116 is connected to one end of the third fluid transfer tube 126 and the third fluid injection port 136 is connected to the other end of the third fluid transfer tube 126.

The first to third pockets 112, 114, and 116 can be individually controlled by individually driving the first to third fluid inlets 132, 134, and 136. For example, fluid may be injected into all of the first, second, and third fluid injection ports 132, 134, 136 to secure a field of view or to hemostasis around the tip without changing the position of the tip.

FIG. 6 is a perspective view showing a state in which only a part of fluid is discharged in the endoscope system shown in FIG. 1;

1 to 6, when fluid is injected into only the second and third fluid inlets 134 and 136, only the second and third pockets 114 and 116 expand and the first pocket 112 The shrinkage state is maintained. In this case, the distal end portion is pushed by the expanding second and third pockets 114 and 116 and moves toward the first pocket 112 in a contracted state. The first to third pockets 112, 114 and 116 may be inflated / deflated individually by similarly injecting / discharging fluids into the first to third fluid inlets 132, 134 and 136 . Therefore, the tip portion can be moved to an arbitrary position.

FIG. 7 is a block diagram showing a procedure using the endoscope system shown in FIG. 1. FIG.

1 to 7, the endoscope guiding tube 120 and the distal end portion are inserted into the human body (S100). In this embodiment, the distal end portion includes the procedure endoscope 10 and the pockets 112, 114, and 116. If the pockets 112,114, 116 are inflated, the pockets 112,114, 116 are caught in the surrounding tissue and can not be inserted. The pockets 112, 114, and 116 are contracted and remain in close contact with the distal end portion. At this time, a medical gel or the like may be applied to the endoscope guiding tube 120 and the distal end portion to facilitate insertion of the endoscope guiding tube 120 and the distal end portion.

The endoscope guiding tube 120 and the distal end can be inserted into various parts of the human body. For example, the endoscope guiding tube 120 and the distal end portion may be inserted into various parts such as the digestive organs, the abdominal cavity, the blood vessel, and the like. In this case, the thickness of the endoscope guide tube and tip of the endoscope system developed for the purpose of being inserted into the blood vessel is smaller than the thickness of the target blood vessel, and the endoscope guide tube of the endoscope system developed for use in the digestive organs is smaller than the endoscope. Thickness.

The endoscope guiding tube 120 and the distal end portion are continuously inserted and guided until the predetermined position is reached.

Subsequently, when the distal end reaches a desired position, fluid is injected through the fluid injection ports 132, 134, and 136 disposed at the other end of the endoscope guiding tube 120 (S110).

In the present embodiment, fluid is injected into all of the first to third fluid injection ports 132, 134, 136 at the time of initial injection. Preferably the same amount of fluid flows into the first to third fluid injection ports 132, 134, 136. When the amount of the fluid flowing into the first to third fluid inlets 132, 134 and 136 is the same, the first to third fluid transfer tubes 122, 124, (112, 114, 116). In another embodiment, the pressure of the fluid flowing through the first to third fluid injection ports 132, 134, 136 may be the same.

During the second and subsequent injections, the amount of fluid injected into the first to third fluid injection ports 132, 134, 136 may vary depending on the position of the tip. This will be described in detail in step S150.

Thereafter, using the fluids introduced through the first to third fluid injection ports 132, 134, 136 and the first to third fluid transmission nibs 122, 124, 126, (112, 114, 116) (S120).

In this embodiment, the amount of the fluid introduced into the first to third pockets 112, 114, and 116 is the same at the time of initial injection so that the tip ends are located at the center of the first to third pockets 112, 114, .

The amount of fluid injected into the first to third fluid injection ports 132, 134, and 136 is different at the time of the second and subsequent injections so that the tip ends are located at the center of the first to third pockets 112, 114, and 116 Not located. For example, if only the fluid is injected into the second and third fluid inlets 134 and 136 and the fluid is discharged into the first fluid inlets 132, the leading end may pass through the second and third pockets 114 116, and is disposed in the direction of the first pocket 112. [

Since the first to third pockets 112, 114 and 116 contain a transparent material and the fluid is transparent, the first to third pockets 112, 114 and 116 are disposed on the front side of the procedure endoscope 10 Even if it does, the field of view is not blocked.

Further, since the internal tissues of the human body are pressurized by the pressures applied to the first to third pockets 112, 114, and 116, it is possible to easily perform hemostasis even if an unexpected situation such as bleeding occurs.

Subsequently, it is checked whether the first to third pockets 112, 114, and 116 are properly formed (S130). When the first to third pockets 112, 114, and 116 are properly formed, the leading end is disposed at a predetermined position.

An image photographed through the camera 12 of the treatment endoscope 10 is displayed on an external monitor (not shown) through the image delivery unit 20 of the endoscope guiding tube 120. The user observes the displayed image through the monitor (not shown), and checks whether the first to third pockets 112, 114, and 116 are properly formed and the tip is positioned in the correct position.

If the first to third pockets 112, 114, and 116 are properly formed and the distal end portion is disposed at a predetermined position, the procedure is performed inside the human body using the procedure endoscope 10 (S140).

The primary procedure is performed by operating the procedure tool 14 from the outside using an image photographed through the camera 12. [ In the first procedure, various treatments such as removal of abnormal tissue in gastrointestinal tract such as gastric mucosa or large intestine, molding of disc, knee joint of spine, etc. can be performed using surgical tool 14.

If the first to third pockets 112, 114, and 116 are not properly formed and the tip is not disposed at the predetermined position, one of the first to third fluid injection ports 132, 134, The fluid injected into one or more of the first to third pockets 112, 114, and 116 is removed at step S150.

The step of removing fluid injected into one or more of the first through third pockets 112, 114, 116 through one or more of the first through third fluid inlets 132, 134, And is performed in accordance with the relative position between the current position and the predetermined position of the tip end.

Fluid inlets through which the fluid is removed from the first to third fluid inlets 132, 134, 136 are related to the direction between the current position and the predetermined position of the tip. That is, the fluid is discharged through fluid inlets corresponding to the pockets (or pockets) located in the direction in which the tip moves.

For example, when the current position of the tip portion is lower than the predetermined position, the fluid is removed through the first fluid inlet 132 corresponding to the first pocket 112 disposed at the upper portion of the tip portion.

Further, the amount of the fluid discharged through a part of the first to third fluid injection ports 132, 134, 136 is related to the position at which the tip is moved. That is, when the amount of the fluid discharged through a part of the first to third fluid injection ports 132, 134, 136 is small, the amount of movement of the tip end is small and the amount of fluid flowing through the first to third fluid injection ports 132, ), The amount of movement of the tip portion is large.

Subsequently, a part of the first to third pockets 112, 114, and 116 is contracted through some of the first to third fluid injection ports 132, 134, and 136 (S160).

The retracted pockets of the first to third pockets 112, 114, 116 relate to the direction between the current position and the predetermined position of the tip. That is, the pockets (or pockets) located in the direction in which the distal end moves are contracted.

For example, if the current position of the tip portion is lower than the predetermined position, the fluid is removed through the first fluid injection port 132 (S150) and the first pocket 112 is contracted. When the first pocket 112 is retracted, the tip portion is pushed up toward the first pocket 112 by the pressure of the second and third pockets 114 and 116 (see FIG. 6).

Also, the amount of shrinkage through some of the first through third pockets 112, 114, 116 is related to the position at which the tip is moved. That is, when the amount of shrinkage through a part of the first to third pockets 112, 114, and 116 is small, the amount of movement of the tip end portion is small and a portion of the first to third pockets 112, 114, If the amount of shrinkage is large, the amount of movement of the tip portion is large.

Subsequently, it is checked whether the first to third pockets 112, 114, and 116 are properly formed (S170). When the first to third pockets 112, 114, and 116 are properly formed, the leading end is disposed at a predetermined position.

If the first to third pockets 112, 114, and 116 are properly formed and the distal end portion is disposed at the predetermined position, the procedure returns to step S140 and the procedure is performed inside the human body using the procedure endoscope 10 (S140 ).

If the first to third pockets 112, 114, and 116 are not properly formed and the tip is not disposed at the predetermined position, one of the first to third fluid injection ports 132, 134, In step S180, the fluid is injected into one or more of the first to third pockets 112, 114, and 116, respectively.

The step of injecting fluid into one or more of the first through third pockets 112, 114, 116 through one or more of the first through third fluid inlets 132, 134, And is performed according to the relative position between the current position and the predetermined position.

Fluid inlets through which the fluid is injected among the first to third fluid inlets 132, 134, 136 are related to the direction between the current position and the predetermined position of the front end. That is, the fluid is injected through fluid inlets corresponding to the pockets (or pockets) located opposite the direction in which the tip moves.

For example, when the current position of the tip is below the predetermined position, the second and third fluid inlets 134, 136 corresponding to the second and third pockets 114, 116 disposed below the tip, Lt; / RTI >

Also, the amount of fluid injected through some of the first to third fluid injection inlets 132, 134, 136 is related to the position at which the tip is moved. That is, when the amount of the fluid injected through a part of the first to third fluid injection ports 132, 134, 136 is small, the amount of movement of the tip end is small and the amount of fluid flowing through the first to third fluid injection ports 132, The larger the amount of fluid to be injected is, the larger the amount of movement of the tip portion is.

Thereafter, the process returns to step S120 to expand some of the first to third pockets 112, 114, and 116 through some of the first to third fluid injection ports 132, 134, and 136 (S120).

Of the first to third pockets 112, 114, 116, the expanding pockets are related to the direction between the current position and the predetermined position of the tip. That is, the pockets (or pockets) located in the opposite direction of the direction in which the tip moves are expanded.

For example, when the current position of the tip portion is lower than the predetermined position, fluid is injected through the second and third fluid injection ports 134 and 136 (S180) and the second and third pockets 114 and 116 ). When the second and third pockets 114 and 116 are inflated, the tip portion is pushed up in the direction of the first pocket 112 by the pressure of the second and third pockets 114 and 116.

Further, the amount of expansion through some of the first to third pockets 112, 114, 116 is related to the position at which the tip is moved. That is, when the amount of expansion through a part of the first to third pockets 112, 114, and 116 is small, the amount of movement of the tip end portion is small, and a part of the first to third pockets 112, 114, If the amount of swelling is large, the amount of movement of the tip portion is large.

The procedure is repeated until the distal end is positioned and the procedure is performed (S140).

When the procedure is completed, all the fluids in the first to third pockets 112, 114, and 116 are discharged through the first to third fluid inlets 132, 134, and 136 (S190).

When all the fluids in the first to third pockets 112, 114 and 116 are discharged through the first to third fluid inlets 132, 134 and 136, the first to third pockets 112, 114, 116 are contracted and attached to the tip end (S200).

Finally, the endoscope guiding tube 120 and the distal end portion are discharged to the outside of the human body (S210).

According to the present invention as described above, the endoscope system includes the pockets disposed at the distal end thereof, so that it is easy to secure the view of the procedure endoscope and to secure the procedure space. In addition, since the fluid inside the pockets and the pockets is transparent, even if the pockets are disposed on the front surface of the endoscope, it is easy to secure a view. Pockets and fluids are harmless to humans, including biocompatible materials.

INDUSTRIAL APPLICABILITY The endoscopic system of the present invention can be used not only for diagnosis and treatment of the inside of a human body but also for industrial use which can be used in various places such as body cavity of an animal, .

While the present invention has been particularly shown and described with reference to exemplary embodiments thereof, it is to be understood that the invention is not limited to the disclosed exemplary embodiments. It is to be understood that various changes and modifications may be made without departing from the scope of the appended claims.

10: a procedure endoscope 12: a camera
14: Procedure tool 20:
112, 114, 116: pocket 120: endoscope guide tube
122, 124, 126: Fluid delivery tubes 132, 134, 136: Fluid inlet

Claims

A surgical endoscope including a camera for generating a video signal;
An endoscope guiding tube connected to the endoscope at one end and inserted into an object, the other end being disposed outside the object, and guiding the endoscope to the inside of the object;
A pocket disposed in the periphery of the endoscope and expanding / retracting in accordance with injection / discharge of the fluid;
A fluid delivery tube disposed along the endoscope guiding tube and connected to the pocket to inject / discharge the fluid; And
And a fluid injection port connected to the fluid transfer tube and disposed outside the object for injecting / discharging the fluid into / from the fluid transfer tube.

The endoscopic system of claim 1, wherein the pocket comprises a transparent material.

2. The endoscopic endoscope according to claim 1, wherein the pockets further include a plurality of the fluid transfer tubes and the plurality of fluid inlets corresponding to the plurality of pockets, Endoscopic system.

4. The endoscopic system of claim 3, wherein the pockets are independently inflated / deflated.

A surgical endoscope including a camera for generating a video signal and a surgical tool working inside the object; An endoscope guiding tube connected to the endoscope at one end and inserted into the inside of the object, the other end being disposed outside the object, and guiding the endoscope to the inside of the object; A plurality of pockets disposed in the periphery of the endoscope and expanding / retracting in accordance with fluid injection / discharge; A plurality of fluid delivery tubes disposed along the endoscope guiding tube and connected to the pockets to inject / discharge the fluid; And a plurality of fluid inlets connected to the fluid transfer tubes and disposed outside the object to inject / discharge the fluid into the fluid transfer tubes, the method comprising:
Inserting the surgical endoscope and the pockets into an object;
Separately inflating / deflating the pockets by individually injecting / discharging the fluid through the fluid inlets;
Repeating the step of separately injecting / discharging the fluid to reach the position of the treatment endoscope at the treatment position when the position of the treatment endoscope does not reach the treatment position; And
And performing the operation inside the object using the surgical tool when the position of the operation endoscope reaches the operation position.