TW202023466A - Medical examination scope guide mechanism - Google Patents

Abstract

This guide mechanism comprises: a guide part having a first guide surface assuming a tapered shape that is smooth, with no protrusions or depressions oriented in the insertion direction; an attachment part for the purpose of attaching, in a removable manner, the guide part to a medical examination scope; a mounting structure integrated with the attachment part, for mounting, in a removable manner, the guide part to the guide mechanism; and a variable support device causing the interval between the attachment part and the mounting structure to be modified relatively to one another.

Description

Guidance mechanism for examination mirror

The present invention relates to a guiding mechanism for a diagnostic scope, such as a diagnostic scope (for example, an endoscope, a videoscope) for optically inspecting a lumen such as an ear cavity or a nasal cavity.

In the past, in terms of the style of the above-mentioned examination mirror, the user’s hand-held operation, such as inserting the examination scope into the lumen, or operating towards the examination subject, was performed by the user. During the examination performed by the mirror, the operation of directing the above-mentioned examination instrument toward the examination subject is performed.

Advanced technical literature Patent literature Patent Document 1: Japanese Special Publication No. 2005-519666

Summary of the invention Problems to be solved by the invention Incidentally, the above-mentioned lumen is a relatively narrow space area. On the other hand, the insertion portion (for example, the distal end portion of the scope) of the above-mentioned examination mirror inserted into the lumen is rigid. In this case, when the inspection scope is inserted into the lumen, the insertion portion (the front end of the scope) and the lumen of the inspection scope are in a state where they can easily contact each other. In this way, depending on the degree of the contact pressure, the lumen may be injured or damaged.

In addition, the above-mentioned examination mirror is operated by hand. On the other hand, the insertion part (the front end of the lens) of the examination mirror has a slender rod shape. In this case, it is extremely difficult to position the direction of the insertion portion (the front end of the mirror) in a certain direction during a medical examination, and the direction of the insertion portion (the front end of the mirror) will always change easily. . As a result, depending on the degree of the change, the subject of examination will deviate from the field of vision of the examination mirror.

In addition, in the examination performed by the above-mentioned examination mirror, for example, it is assumed that there is a case where a specimen is to be taken out or surgically treated. In this case, while operating the examination mirror, it is also necessary to operate the above-mentioned examination instruments, but a certain degree of proficiency is required to operate both by hand. In this way, depending on the level of proficiency, it may become difficult to operate the examination instrument toward the examination subject, or it may become impossible to operate.

Therefore, the object of the present invention is to provide a guiding mechanism for a medical examination mirror that has both the insertion guiding function and the positioning guiding function of the medical examination mirror and the operation guiding function of the medical instrument.

Means to solve the problem In order to achieve such an objective, the guiding mechanism for a medical examination mirror of the present invention includes a guiding part having a first guiding surface, and the first guiding surface becomes a smooth and tapered shape without unevenness toward the insertion direction; and a mounting part for guiding the The part is detachably installed on the examination mirror; the installation structure allows the guide part to be detachably installed on the guiding mechanism and is supported on the installation part; and the variable support device makes the distance between the installation part and the installation structure Relatively change.

Invention effect According to the present invention, the guide portion can be made into a disposable type, and the diagnostic scope can be safely guided toward the lumen by contracting the variable support device, and the diagnostic instrument can be extended by extending the variable support device (For example, tweezers, scalpel) are accurately and efficiently guided toward the examination subject.

The form used to implement the invention "Examination mirror (for example, video endoscope 1)" Figs. 1 to 3 show the style of the examination mirror according to one embodiment of the present invention. In this case, as an examination scope, for example, an examination scope (for example, an endoscope, a video endoscope) that optically examines a lumen such as an ear cavity or a nasal cavity can be assumed. In this examination mirror, a guide mechanism 22 (refer to FIG. 4) described later is detachably attached. In addition, in Figs. 1 to 3, as an example of the examination mirror, a video endoscope for ear cavity examination is shown.

As shown in Figures 1 to 3, the video endoscope 1 for ear cavity examination (hereinafter referred to as video endoscope) of the present embodiment can hold the examination subject 2 in the field of view, and take pictures of the examination subject 2. Video is recorded and visualized on the display 3 (display surface 3s). Here, in terms of the examination target 2, for example, the ear hole (external auditory meatus), the tympanic membrane, etc., can be assumed to be everywhere in the ear cavity (lumen). The video endoscope 1 has special accessories 4 for diagnosing these cavities.

Here, as an example of a dedicated accessory, accessory 4 for ear cavity examination (also called tympanic membrane examination mirror) is applied. The accessory 4 for ear cavity examination is provided with an ear cavity insertion portion 4a (also referred to as a lumen insertion portion) that can be inserted into the ear cavity (lumen). The ear cavity (lumen) insertion portion 4a is rigid and has a cylindrical shape extending in a straight line.

The ear cavity (lumen) insertion part 4a is supported by the support part 4b. When viewed in the direction of gravity Gd (refer to FIG. 1), the support portion 4b is configured along the vertical direction. The ear cavity (lumen) insertion portion 4a is supported on the upper end of the support portion 4b (specifically, the support portion 4d). In addition, the lower end of the supporting portion 4b is attached to the mirror body 6 through the connector 5.

The connector 5 has a first connection portion 5a, a second connection portion 5b, and a release handle 5c. The first connecting portion 5a is provided on the mounting portion 6a (the uppermost side) of the mirror body 6. The second connecting portion 5b is provided at the lower end of the support portion 4b. In this case, by connecting the connecting portions 5a and 5b of both sides to each other, the attachment 4 for the ear cavity examination can be attached to the mirror body 6. In addition, by pulling the release handle 5c, the interconnection state of the connecting portions 5a and 5b can be released.

In addition, a mirror tip portion 4c is provided in the ear cavity (lumen) insertion portion 4a (the accessory 4 for ear cavity examination). The distal end portion 4c of the mirror is configured to be capable of being inserted into the examination subject 2, or operated along the examination subject 2, for example. In the mirror tip portion 4c, an imaging unit 12 (refer to FIG. 3) described later is arranged. The image of the examination subject 2 is imported into the mirror body 6 through the imaging unit 12, and is used for photography, video recording, and imaging. In addition, the details of the imaging unit 12 will be described later.

The mirror body 6 is provided with a grip portion 6b that can be held by the user's fingers and a drop-off preventing portion 6c. Viewed from the direction of gravity Gd, the grip portion 6b is formed at the lower portion of the mirror body 6, in other words, is formed directly below the mounting portion 6a. The grip portion 6b has an oblong outline that can be held by a user with one hand (right hand, left hand). Viewed from the direction of gravity Gd, the drop-off preventing portion 6c is a portion adjacently provided on the upper side of the grip portion 6b. The falling-off prevention part 6c is configured to protrude further than the grip part 6b.

In addition, the mirror body 6 is provided with an operating portion 6d, and the operating portion 6d is provided with a shooting button 7 and a recording button 8. Viewed from the direction of gravity Gd, the shooting button 7 and the recording button 8 are arranged side by side in the vertical direction. The operation portion 6d is located between the mounting portion 6a (top) and the grip portion 6b.

In addition, the mirror body 6 is provided with a light source 9 and the above-mentioned display 3. The display 3 is configured to allow the examination subject 2 to be imaged on its display surface 3s. The display 3 is located on the opposite side of the operation part 6d. The display surface 3s of the display 3 is located in the opposite direction of the operation part 6d (the operation surface provided with the shooting button 8 and the recording button 9). Viewed from the direction of gravity Gd, the display 3 is located at a position shifted downward from the mounting portion 6a (top). As the light source 9, an existing light-emitting element (LED) can be applied.

In addition, the mirror body 6 is provided with a button group 10, and the button group 10 includes a power button 10a (see FIG. 1), a menu button, and the like. As the power source, for example, three primary batteries 11 (size 3 batteries, AA batteries) are used (refer to FIG. 2(b)). The button group 10 is arranged on the side surface of the mirror body 6 between the operation portion 6d and the display 3.

As shown in FIG. 3, the imaging unit 12 is configured to be able to set the outer dimension of the lens tip portion 4c to an ultrafine diameter of several millimeters or less, for example. The imaging unit 12 has a hollow cylindrical housing body 14 that can be arranged at the front end portion 4c of the lens, a plurality of light-emitting parts 15, and a light-receiving part 16. The light-emitting part 15 and the light-receiving part 16 are housed inside the housing body 14. The light emitting unit 15 is configured to output light toward the examination subject 2. The light receiving unit 16 is configured to be able to input an image from the examination subject 2 irradiated with light. Inside the casing body 14, the light emitting part 15 is laid out along the periphery of the light receiving part 16.

In addition, the camera unit 12 has a holder 17 in the shape of a hollow square column. The holder 17 is configured to hold the light emitting unit 15 and the light receiving unit 16 in the housing body 14. The holder 17 is provided with four wall portions 17 a facing each other in parallel to divide the inside of the housing body 14. The four wall portions 17a are adjacent wall portions 17a orthogonal to each other.

Here, in a state where the holder 17 has been housed in the housing body 14, the inside of the housing body 14 is divided into a first area 18 and a second area 19. The second area 19 is arranged along the circumference of the first area 18. The first region 18 has a square cross-sectional profile surrounded by four wall portions 17a. The second area 19 has a cross-sectional profile surrounded by the wall portion 17 a and the housing body 14. The light receiving unit 16 is accommodated in the first area 18. The light emitting unit 15 is accommodated in the second area 19.

In the light emitting unit 15, a light guide 20 (for example, an optical fiber 20f) having two ends and the light source 9 are connected. One end of the light guide 20 is accommodated in the housing body 14 of the camera unit 12. The other end of the light guide 20 is configured to allow light from the light source 9 to enter.

An objective lens 21 and a sensor (not shown) are provided in the light receiving unit 16. The sensor is arranged behind the objective lens 21. The objective lens 21 is fixed to the holder 17. As the sensor, imaging elements such as CMOS or CCD can be applied.

As described above, according to the video endoscope 1 of this embodiment, the ear cavity (lumen) can be inserted into the ear cavity (lumen) at the time of the diagnosis in a state where the user holds the grip 6b with his fingers. 4a (the front end of the mirror 4c) and the examination subject 2 (the ear cavity) are positioned in a linear alignment. Thereby, the user can look directly at the display 3, and the display 3 can be positioned at a position avoiding the user's line of sight 13. As a result, it is possible to improve the insertability and operability of the mirror tip portion 4c of the examination subject 2. "Guide mechanism for examination mirror 22"

In FIGS. 4 to 7, the guide mechanism 22 applied to the above-mentioned video endoscope 1 is shown. The guide mechanism 22 has a disposable function of the guide part 23 and a function of changing (variable) the position of the guide part 23. In order to realize such a function, the guide mechanism 22 includes a hollow guide portion 23, an attachment portion 24, a variable support device 25 that relatively changes (changes) the distance between the guide portion 23 and the attachment portion 24, and an installation structure 28.

Hereinafter, after describing the disposable function of the guide part 23, the function (displacement function) of changing (changing) the position of the guide part 23 will be explained. In this case, the installation structure 28 is a structure for realizing a disposable function. In addition, the variable support device 25 is a structure for realizing a displacement function. "Disposable function of guide 23"

The guide part 23 has two ends (base end 23p, front end 23t) in the insertion direction of the video endoscope 1 (the ear cavity (lumen) insertion part 4a). The inside of the guide part 23 is formed from the base end 23p to the front end 23t, in other words, it is made to penetrate between the openings (base end opening Hp, the front end opening Ht) mentioned later, and penetrate into a hollow shape. In this case, in a state where the guide mechanism 22 has been applied to the video endoscope 1, the guide portion 23 is configured to be able to accommodate the ear cavity (lumen) insertion portion 4a.

In addition, the guide portion 23 may be configured to accommodate the entire ear cavity (lumen) insertion portion 4a, or may be configured to accommodate a part of the ear cavity (lumen) insertion portion 4a. In either case, the guide portion 23 is preferably configured to accommodate at least the lens tip portion 4c.

In addition, the guide portion 23 has a tapered shape as a whole in the insertion direction of the video endoscope 1 (the ear cavity (lumen) insertion portion 4a). In this case, the guide portion 23 has a contour (outer contour, inner contour) that becomes a tapered shape from the base end 23p toward the front end 23t.

The outer contour defines the outer shape of the guide portion 23, and on the outer surface of the guide portion 23, a first guide surface 23a is formed. On the other hand, the inner contour defines the inner surface shape of the guide portion 23 (that is, the hollow inner surface shape on the opposite side of the outer surface), and the second guide surface 23b is formed on the inner surface of the guide portion 23.

The outer surface (first guide surface 23a) of the guide portion 23 has a tapered shape that becomes smooth from the base end 23p of the guide portion 23 toward the front end 23t. The first guide surface 23a has the following functions: as a guide when the video endoscope 1 is inserted into the ear cavity (lumen), and to direct the video endoscope 1 inserted into the ear cavity (lumen) toward the examination subject 2 (For example, tympanic membrane) The function of stably positioning and guiding.

The inner surface (second guide surface 23b) of the guide portion 23 has a tapered shape that becomes smooth as it goes from the base end 23p of the guide portion 23 to the tip 23t. For example, as shown in FIG. 4, the second guide surface 23b has a function of accurately and efficiently placing the later-described diagnostic tool 26 (for example, forceps, scalpel) in a state where the guide portion 23 has been positioned on the examination target 2. The function of guiding toward the ear cavity 2a or tympanic membrane 2b of the examination subject 2, for example.

In FIGS. 4-7, as an example of a tapered shape, the 1st guide surface 23a and the 2nd guide surface 23b have a smooth conical shape. In this case, the so-called smooth conical shape can be defined as a conical surface without unevenness. In addition, in accordance with the purpose or application of the video endoscope 1, the outline of the guide portion 23 may be set to a shape other than the conical shape.

In addition, openings (base end opening Hp, front end opening Ht) are provided at both ends (base end 23p, front end 23t) of the guide portion 23. The base end opening Hp is configured to be larger than the tip opening Ht. The proximal opening Hp and the distal opening Ht are arranged to face each other in parallel. The tip opening Ht is configured to be slightly larger than the outer dimension of the tip portion of the ear cavity (lumen) insertion portion 4a (that is, the lens tip portion 4c). In addition, as long as the proximal opening Hp has a shape larger than the distal opening Ht, it may be configured in any shape such as a circle, a rectangle, or an ellipse.

Here, as shown in FIG. 6, assuming that the mirror tip portion 4c and the tip opening Ht are both configured in a circular pattern, the inner diameter (diameter) D1 of the tip opening Ht is preferably set to be larger than the outer diameter of the mirror tip portion 4c. The diameter (diameter) D2 is slightly larger. In addition, depending on the purpose or application of the video endoscope 1, the mirror tip portion 4c and the tip opening Ht may be set to shapes other than circular. 「Installation part 24」

The mounting part 24 is configured to be able to mount the video endoscope 1 (refer to FIG. 4). The mounting part 24 is to detachably mount the support part 4d which supports the said ear cavity (lumen) insertion part 4a. In FIG. 4, as an example, the support part 4d has a rectangular three-dimensional shape, and it is integrally formed in the attachment 4 for an ear cavity examination. The supporting portion 4d is configured to be able to support the lens base end portion 4e (that is, the site on the opposite side of the lens tip portion 4c) of the ear cavity (lumen) insertion portion 4a.

In addition, the mounting portion 24 has a mounting hole 24h, and the mounting hole 24h is configured by penetrating the mounting portion 24. The penetration direction of the mounting hole 24h is set to be parallel along the direction in which the ear cavity (lumen) insertion portion 4a extends. The mounting hole 24h is arranged to face the base end opening Hp and the front end opening Ht. The hole shape (hole outline) of the mounting hole 24h is configured to be the same as or slightly larger than the outer outline of the support portion 4d (that is, the rectangular three-dimensional shape). With this, in a state where the supporting portion 4d has been inserted into the mounting hole 24h, the mounting portion 24 can be mounted on the supporting portion 4d without looseness (stably). "Installation Structure 28"

The mounting structure 28 is supported by the mounting portion 24 through a variable support device 25 described later. The installation structure 28 is a structure for realizing the disposable function of the guide portion 23. According to this structure, the guide portion 23 can be detachably attached to the guide mechanism 22. As a result, when the video endoscope 1 is used (for example, when the examination object 2 is photographed (recorded)), the guide part 23 can be installed on the guide mechanism 22 first, and after use, only the guide part 23 can be removed from The guide mechanism 22 is removed and discarded. This will be specifically explained below.

The mounting structure 28 has two ends (base end 28p, front end 28t) in the insertion direction of the video endoscope 1 (the ear cavity (lumen) insertion portion 4a). The inside of the mounting structure 28 is made from the base end 28p to the front end 28t, in other words, it is made to penetrate between openings (base end opening Kp, the front end opening Kt) mentioned later, and penetrate into a hollow shape.

In FIGS. 5 to 7, as an example, the installation structure 28 has a profile (outer profile, inner profile) that is tapered from the base end 28p toward the tip 28t as a whole. The mounting structure 28 has a base end 28p connected to a variable support device 25 described later. Thereby, the installation structure 28 is supported by the installation portion 24 through the variable supporting device 25.

The outer contour defines the outer shape of the installation structure 28, and an installation outer surface 28a and an installation groove 28g are provided on the outer surface of the installation structure 28. On the other hand, the inner contour defines the inner surface shape of the installation structure 28 (in other words, the hollow inner surface shape on the opposite side of the outer surface), and a gate surface is provided on the inner surface of the installation structure 28. ) 28b.

The installation outer surface 28a and the gate surface 28b have a tapered shape that becomes smooth as they move from the base end 28p of the installation structure 28 toward the front end 28t. In the drawing, as an example, the installation outer surface 28a and the gate surface 28b have a smooth conical shape. The so-called smooth conical shape can be defined as a conical surface without unevenness. In addition, in accordance with the purpose or application of the video endoscope 1, the outline of the installation structure 28 (installation outer surface 28a, gate surface 28b) may be set to a shape other than a conical shape.

Here, the installation outer surface 28a is configured to support the installation inner surface 23c of the guide portion 23 described later when the guide portion 23 is installed to the guide mechanism 22 first. The installation outer surface 28a has a tapered (conical) shape with no unevenness except for the installation groove 28g, and has the same contour shape as the installation inner surface 23c of the guide portion 23 described later. Then, in the state where the guide portion 23 is mounted on the guide mechanism 22, the mounting outer surface 28a and the mounting inner surface 23c are in contact with each other in a planar shape without a gap.

The installation groove 28g provided on the installation outer surface 28a of the installation structure 28 is formed in a spiral shape across the installation outer surface 28a approximately half a circumference in the circumferential direction. In the drawings, as an example, the installation groove 28g has a spiral shape that advances in the counterclockwise direction (left direction) when viewed from the base end 28p of the installation structure 28 toward the front end 28t. In other words, the installation groove 28g has a spiral shape that advances in the clockwise direction (right direction) when viewed from the front end 28t of the installation structure 28 toward the base end 28p.

Such an installation groove 28g is configured to be able to engage with the convex portion 23d of the guide portion 23 (installation inner surface 23c) described later and move along the installation groove 28g. In addition, since the size and depth of the installation groove 28g are set in accordance with, for example, the protrusion amount and protrusion length of the convex portion 23d described later, it is not particularly limited here.

Moreover, openings (base end opening Kp, front end opening Kt) are provided at both ends (base end 28p, front end 28t) of the mounting structure 28, and the base end opening Kp is configured to be larger than the front end opening Kt. The proximal opening Kp and the distal opening Kt are arranged to face each other in parallel. The base end opening Kp and the front end opening Kt may be configured in any shape such as a circle, a rectangle, or an ellipse. "Additional structure of guide portion 23 corresponding to installation structure 28"

As shown in FIGS. 5-7, the guide part 23 has the installation area 23r, the installation inner surface 23c, and the convex part 23d.

The installation area 23r is configured to be installable on the above-mentioned installation structure 28 (installation outer surface 28a). The installation area 23r is defined across a range from the base end 23p of the guide part 23 to the middle of the front end 23t. In this case, since the range of the installation area 23r is set in accordance with the size and width of the installation structure 28 (installation outer surface 28a), it is not particularly limited here.

The installation inner surface 23c and the convex portion 23d are provided on the inner surface of the guide portion 23 within the range of the installation area 23r. The installation inner surface 23c has a conical shape with no unevenness except for the convex portion 23d, and has the same contour shape as the outer surface of the installation structure 28 (installation outer surface 28a). In addition, in the drawings, as an example, the installation inner surface 23c is configured to be continuous with the second guide surface 23b of the guide portion 23 described above.

The convex portion 23d is configured to protrude inward from the installation inner surface 23c. The protrusion amount or protrusion length of the convex portion 23d is set in accordance with the size and depth of the installation groove 28g of the above-mentioned installation structure 28, so it is not particularly limited here.

As described above, according to the throw-away function of the present embodiment, it is possible to configure only the guide part 23 of the guide mechanism 22 (the guide part 23, the mounting part 24, and the variable support device 25 described later) to be thrown away. Thereby, the total amount of waste can be reduced compared to the entire guide mechanism 22 in a disposable style, and as a result, the cost required for disposal can be reduced.

In addition, according to the disposable function of the present embodiment, for example, in a state where the user holds the guide portion 23 with a finger, the installation inner surface 23c of the guide portion 23 is arranged to cover the installation outer surface 28a of the installation structure 28 (see Fig. 6), and the guide part 23 is rotated in the clockwise direction (right direction). In this way, the convex portion 23d of the installation inner surface 23c is engaged with the installation groove 28g of the installation outer surface 28a and moves along the installation groove 28g. At this time, with the movement of the convex portion 23d, the installation inner surface 23c will be pulled toward the installation outer surface 28a. In other words, the installation outer surface 28a and the installation inner surface 23c are close to each other. Thereby, the installation outer surface 28a and the installation inner surface 23c will be in contact with each other in a planar shape without a gap. As a result, the guide portion 23 (installation inner surface 23c) is supported by the installation structure 28 (installation outer surface 28a). Therefore, when photographing (recording) the examination subject 2 with the video endoscope 1, the guide part 23 can be stably installed on the guide mechanism 22 first without looseness. On the other hand, after use, as long as the guide portion 23 is rotated counterclockwise (leftward), only the guide portion 23 can be removed from the guide mechanism 22 in a simple and short time. "Displacement function of variable support device 25"

As shown in FIG. 8, the variable support device 25 has a guide member 25a, a sliding member 25b, and a positioning and fixing member 25c, and is used to change (change) the position of the guide portion 23. In addition, FIG. 9 is a cross-sectional view showing the internal structure of the positioning and fixing member 25c.

The guide member 25a has both ends (base end 25a-1, front end 25a-2), and is formed into a rod shape extending straight from the base end 25a-1 to the front end 25a-2. The base end 25a-1 of the guide member 25a is connected to the attachment portion 24 described above. Here, in a state where the mounting portion 24 has been mounted on the video endoscope 1 (support portion 4d), the guide member 25a extends in parallel with the ear cavity (lumen insertion portion 4a).

In addition, the guide member 25a is provided with a guide groove Gr. The guide groove Gr is formed by recessing a part of the guide member 25a, and extends along the guide member 25a. The size (width, depth) of the guide groove Gr is set according to, for example, the size or shape of the guide member 25a, so it is not particularly limited here. In this case, the guide groove Gr is preferably set to a size (width, depth) that does not reduce the rigidity or strength of the guide member 25a.

The sliding member 25b is configured to surround the guide member 25a. In Fig. 8, as an example, the guide member 25a has a polygonal outline in cross section. The sliding member 25b has a surrounding portion 25b-1 surrounding the guide member 25a. The inner diameter profile of the surrounding portion 25b-1 is set to be approximately the same (or slightly larger) with the outer profile of the guide member 25a. Thereby, the sliding member 25b can be smoothly moved (moved back and forth) along the guide member 25a without looseness.

In addition, the sliding member 25b has a supporting portion 25b-2. The support part 25b-2 is continuously comprised from the said surrounding part 25b-1, and is arrange|positioned so that it may cover a part of the guide groove Gr. The supporting portion 25b-2 supports the installation structure 28 described above. In the example of FIG. 8, the base end 28p of the installation structure 28 is connected to the support part 25b-2, and is supported.

According to this configuration, the sliding member 25b is moved (moved back and forth) along the guide member 25a. Following this, the installation structure 28 moves (moves back and forth) along the guide member 25a. At this time, the guide portion 23 installed in the installation structure 28 moves (moves back and forth) along the guide member 25a. Thus, the position of the guide portion 23 can be changed (varied).

The positioning and fixing member 25c includes a ball spring Bs and a fixing screw Fs. The ball spring Bs is configured to restrict the free movement (back and forth movement) of the sliding member 25b and to temporarily stop (position) the sliding member 25b at the position after the movement. The fixing screw Fs is configured to be able to fix the sliding member 25b that has stopped (positioned) to the guide member 25a.

In FIG. 9, an example of the positioning and fixing member 25c is shown. The ball spring Bs includes a housing Bs-1, a spring Bs-2, and a ball Bs-3. In the state where the sliding member 25 is screwed-in, the housing Bs-1 partially protrudes into the guide groove Gr. The spring Bs-2 and the ball Bs-3 are accommodated in the housing Bs-1. The ball Bs-3 is maintained in a state of being given potential energy by the spring Bs-2 at any time. In this state, the ball Bs-3 contacts the bottom surface Gm of the guide groove Gr.

In this case, a frictional force (frictional resistance) always acts between the ball Bs-3 and the bottom surface Gm of the guide groove Gr. Thereby, the free movement (back and forth movement) of the sliding member 25b is restricted. Then, the sliding member 25b temporarily stops (positions) at the position after the movement.

On the other hand, the fixing screw Fs includes an operation part Ms and a screw part Ps. The screw part Ps is screwed into the screw hole Hs which penetrates the sliding member 25b (surrounding part 25b-1). In this case, the operation part Ms is rotated in the forward direction, and the contact surface Tm of the fixing screw Fs is brought into contact with the back surface Rm of the guide member 25a. Thereby, the sliding member 25b becomes a state fixed to the guide member 25a. On the other hand, the operation part Ms is rotated in the reverse direction, and the contact surface Tm of the fixing screw Fs is separated from the back surface Rm of the guide member 25a. Thereby, the sliding member 25b is in a state (movable state) where it is temporarily stopped (positioned) in the guide member 25a.

As described above, according to the displacement function of the present embodiment, by shrinking or extending the variable support device 25, the distance between the mounting portion 24 and the mounting structure 28 (guide portion 23) can be relatively changed (changed). For example, the interval can be changed (varied) to any of the preset first use (see FIG. 10) and second use (see FIG. 11).

In FIG. 10, the guide mechanism 22 adjusted for the first purpose is detachably attached to the video endoscope 1. In this case, the support part 4d is inserted into the mounting hole 24h of the mounting part 24 through the ear cavity (lumen) insertion part 4a. Thereby, the mounting portion 24 can be detachably mounted on the supporting portion 4d. At this time, a part of the ear cavity (lumen) insertion portion 4a including the lens tip portion 4c is housed in the hollow inside of the guide portion 23. Then, the front end surface (light emitting portion 15 and light receiving portion 16) of the mirror front end portion 4c is positioned at the front end opening Ht of the guide portion 23.

In FIG. 11, the guide mechanism 22 adjusted for the second purpose is detachably attached to the video endoscope 1. In this case, the support part 4d is inserted into the mounting hole 24h of the mounting part 24 through the ear cavity (lumen) insertion part 4a. Thereby, the mounting portion 24 can be detachably mounted on the supporting portion 4d. At this time, a part of the ear cavity (lumen) insertion portion 4a including the lens tip portion 4c is housed in the hollow inside of the guide portion 23. Then, the front end surface (light emitting portion 15 and light receiving portion 16) of the mirror front end portion 4c is separated from the front end opening Ht of the guide portion 23 (in other words, at a position retracted more than the front end opening Ht) and positioned.

According to such a second application, the operation passage 27 is secured between the ear cavity (lumen) insertion portion 4a (the lens tip portion 4c) and the guide portion 23 (the second guide surface 23b). The operation passage 27 is configured to have a width (size) that can smoothly insert a diagnostic tool 26 such as forceps or a scalpel.

Here, the examination tool 26 is inserted toward the inside of the guide part 23 from the proximal opening Hp. At this time, the examination tool 26 is guided along the second guide surface 23b. The second guide surface 23b has a tapered (conical) shape that tapers toward the tip opening Ht. Thereby, the examination tool 26 guided along the 2nd guide surface 23b is guided toward the front-end opening Ht, and is sent out from the front-end opening Ht. Thus, the examination tool 26 can be operated from the front end opening Ht toward the examination subject 2 (for example, the tympanic membrane 2b).

As described above, according to the displacement function of this embodiment, it is possible to secure the operation passage 27 (refer to FIG. 11) between the ear cavity (lumen) insertion portion 4a (the lens tip portion 4c) and the guide portion 23 (the second guide surface 23b). ). At this time, the second guide surface 23b functions to guide the examination instrument 26 toward the ear cavity 2a. Thereby, regardless of the level of proficiency, anyone can easily operate both the video endoscope 1 and the examination instrument 26 simultaneously by hand. As a result, in the examination with the video endoscope 1, it is possible to operate the examination tool 26 toward the examination subject 2 (for example, the tympanic membrane 2b) more easily and accurately. Therefore, in the diagnosis performed by the video endoscope 1, the operation of the diagnosis instrument 26 such as tweezers or scalpel can be performed safely and without error while operating the video endoscope 1.

In addition, the variable support device 25 shown in FIG. 8 is only an example. Instead of the above-mentioned guide member 25a, sliding member 25b, and positioning and fixing member 25c, for example, a telescopic technology such as a bellows mechanism is used to make the mounting portion 24 and The clearance of the mounting structure 28 may be relatively changed (changed), or the clearance between the mounting portion 24 and the mounting structure 28 may be relatively changed (changed) by the combination of cylinder and piston technology. In short, as long as it is a technique that can relatively change (change) the gap between the mounting portion 24 and the mounting structure 28, there is no limitation. "Other functions and effects of the guidance mechanism 22 of this embodiment"

According to this embodiment, when the video endoscope 1 is inserted into the examination target 2 (for example, the ear cavity 2a) (see FIG. 4), the guide portion 23 (first guide surface 23a) of the guide mechanism 22 moves along the ear cavity 2a, Then, the ear cavity (lumen) insertion portion 4a (the mirror tip portion 4c) is advanced into the ear cavity 2a. At this time, the first guide surface 23a functions as a guide when inserting the ear cavity (lumen) insertion portion 4a (lens tip portion 4c) into the ear cavity 2a. During this period, the ear cavity (lumen) insertion portion 4a (the front end portion of the mirror 4c) will maintain the state of being accommodated in the guide portion 23. Thereby, the ear cavity (lumen) insertion portion 4a (the lens tip portion 4c) and the ear cavity 2a do not directly contact each other. As a result, it is possible to insert the ear cavity (lumen) insertion portion 4a (the mirror tip portion 4c) into the ear cavity 2a safely and reliably.

According to the present embodiment, the guide portion 23 (first guide surface 23a) of the guide mechanism 22 has a tapered (conical) shape that tapers from the base end 23p toward the front end 23t. Here, when the video endoscope 1 is inserted into the examination subject 2 (for example, the ear cavity 2a), after the guide portion 23 (first guide surface 23a) moves from the tip 23t into the ear cavity 2a, the aperture is smaller than the ear cavity 2a The larger part will contact the ear cavity 2a soon. Thereby, the movement of the guide part 23 (1st guide surface 23a) is prevented. At this time, the advancement of the ear cavity (lumen) insertion portion 4a (the mirror tip portion 4c) also stops. As a result, the ear cavity (lumen) insertion portion 4a (the front end portion of the mirror 4c) can be prevented from occurring in advance, which may cause erroneous contact with the examination subject 2 (for example, the tympanic membrane 2b).

According to this embodiment, as described above, when the movement of the guide portion 23 (first guide surface 23a) is prevented, the guide portion 23 (first guide surface 23a) maintains a state of being supported by a part of the inner wall of the ear cavity 2a . At this time, the ear cavity (lumen) insertion portion 4a (the mirror tip portion 4c) accommodated in the guide portion 23 is also maintained in a state of being supported by a part of the inner wall of the ear cavity 2a. Thereby, it becomes easy to position the direction of the ear cavity (lumen) insertion portion 4a (the lens tip portion 4c) in a certain direction during the examination. As a result, the examination object 2 (for example, the tympanic membrane 2b) can be positioned within the field of view of the video endoscope 1 simply and accurately.

1: Video endoscope for ear cavity examination (examination mirror) 2: Examination object 2a: ear cavity 2b: Tympanic membrane 3: display 3s: display surface 4: Accessories for ear cavity examination 4a: Ear cavity (tube cavity) insertion part 4b: Support 4c: Mirror tip 4d, 25b-2: support part 4e: Base end 5: Connector 5a: The first connection part 5b: 2nd connection part 5c: Lift the handle 6: Mirror body 6a, 24: Installation department 6b: Grip 6c: Prevent falling part 6d, Ms: Operation part 7: Photography button 8: Recording button 9: light source 10: Button group 10a: Power button 11: Primary battery 12: Camera unit 13: The user's sight 14: Shell body 15: Light emitting part 16: Light receiving part 17: Holder 17a: Wall 18: Zone 1 19: Zone 2 20: Light guide 20f: optical fiber 21: Objective 22: Guidance mechanism for examination mirrors 23: Guidance 23a: The first guide surface 23b: 2nd guide surface 23c: Install the inner surface 23d: convex 23p, 25a-1, 28p: base end 23r: Installation area 23t, 25a-2, 28t: front end 24h: mounting hole 25: Variable support device 25a: Guide member 25b: Sliding member 25b-1: Surrounding part 25c: Positioning and fixing member 26: Diagnostic equipment 27: Operating Path 28: Installation structure 28a: Installation outside 28b: Gateway surface 28g: installation groove Bs: ball spring Bs-1: Shell Bs-2: Spring Bs-3: Ball D1: inner diameter D2: Outer diameter Fs: fixing screw Gd: gravity direction Gm: bottom surface Gr: Guide groove Hp, Kp: base end opening Ht, Kt: front opening Hs: screw hole Ps: Screw part Rm: back Tm: contact surface

Fig. 1 is a diagram schematically showing a style of a diagnostic mirror to which a guiding mechanism according to a first embodiment of the present invention can be applied.

Fig. 2(a) is a plan view of the mirror body as seen from the display side, Fig. 2(b) is a side view of the mirror body, and Fig. 2(c) is a plan view of the mirror body as seen from the operating part side.

Fig. 3 is a perspective view of an imaging unit applied to the front end of the examination mirror.

Fig. 4 is a perspective view showing a state where the diagnostic scope is inserted into a lumen through a guiding mechanism.

Fig. 5 is a perspective view showing the internal structure of the guide portion.

Fig. 6 is a perspective view showing the process of installing the guide mechanism to the examination mirror.

Fig. 7 is an exploded perspective view in which only the guide part is a disposable type.

Fig. 8 is a perspective view showing the configuration of a variable support device.

Fig. 9 is a cross-sectional view taken along line F9-F9 in Fig. 8.

Fig. 10 is a perspective view showing a state in which the variable support device has been contracted.

Fig. 11 is a perspective view showing a state in which the variable support device has been extended.

1: Video endoscope for ear cavity examination

4: Accessories for ear cavity examination

4a: Ear cavity (tube cavity) insertion part

4c: Mirror body

4d: Support

4e: Base end

22: Guiding agency

24: Installation Department

24h: mounting hole

25: Variable support device

25a: Guide member

25a-1: Base end

25a-2: front end

25b: Sliding member

25b-1: Surrounding part

25b-2: Support part

25c: Positioning and fixing member

28: Installation structure

28a: Installation outside

28g: installation groove

28p: base end

Bs: ball spring

Fs: fixing screw

Gr: Guide groove

Claims (2)

A guiding mechanism for a diagnosis mirror is a guiding mechanism that is detachably installed on a diagnosis mirror with a lumen insertion part inserted into the lumen, and has: The guide portion accommodates at least the front end of the lumen insertion portion, and has a first guide surface, and the first guide surface becomes a smooth and tapered shape with no unevenness toward the insertion direction of the lumen insertion portion; and The mounting part is used to detachably mount the guide part on the examination mirror, When the lumen insertion portion is inserted into the lumen in a state where the guide portion has been mounted on the examination scope, the first guide surface of the guide portion moves along the lumen, thereby making the lumen The insertion part advances along the lumen without contacting the lumen, The guide portion has an outer contour and an inner contour, and becomes a smooth and tapered shape with no unevenness toward the insertion direction of the lumen insertion portion, And has: The first guide surface is defined by the outer contour, and is formed on the outer surface of the guide portion; and The second guide surface is defined by the aforementioned inner contour and is formed on the inner surface of the aforementioned guide portion, In the examination by the examination mirror, when a predetermined examination instrument is inserted into the lumen, the examination instrument is guided along the second guide surface of the guide part, The guide mechanism is further provided with an installation structure in which the guide part is detachably attached to the guide mechanism, and is supported by the mounting part, The aforementioned installation structure has an outer surface and an inner surface, and has: The installation surface is arranged on the aforementioned outer surface so that the aforementioned guiding surface can be detachably installed; and The gate surface is set on the aforementioned inner surface, When the predetermined examination instrument is inserted into the lumen with the guide part installed on the installation surface of the installation structure, the examination instrument is guided along the gate surface of the installation structure The aforementioned second guide surface of the part is guided, The guide mechanism is further provided with a variable support device for relatively changing the interval between the mounting portion and the mounting structure. Such as the guiding mechanism for the examination mirror of claim 1, wherein the aforementioned variable support device has: The guide member extends parallel to the aforementioned lumen insertion portion and is connected to the aforementioned mounting portion; The sliding member can move along the aforementioned guide member and is connected with the aforementioned installation structure; and The positioning and fixing member enables the sliding member to position and fix the guide member.

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