WO2006035566A1 - 挿入装置 - Google Patents
挿入装置 Download PDFInfo
- Publication number
- WO2006035566A1 WO2006035566A1 PCT/JP2005/015775 JP2005015775W WO2006035566A1 WO 2006035566 A1 WO2006035566 A1 WO 2006035566A1 JP 2005015775 W JP2005015775 W JP 2005015775W WO 2006035566 A1 WO2006035566 A1 WO 2006035566A1
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- WO
- WIPO (PCT)
- Prior art keywords
- guide tube
- propulsive force
- insertion portion
- guide
- spiral
- Prior art date
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/005—Flexible endoscopes
- A61B1/0051—Flexible endoscopes with controlled bending of insertion part
- A61B1/0055—Constructional details of insertion parts, e.g. vertebral elements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00147—Holding or positioning arrangements
- A61B1/00148—Holding or positioning arrangements using anchoring means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00147—Holding or positioning arrangements
- A61B1/0016—Holding or positioning arrangements using motor drive units
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/31—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the rectum, e.g. proctoscopes, sigmoidoscopes, colonoscopes
Definitions
- the present invention relates to an insertion device for introducing a medical device such as an insertion portion of an endoscope into a body cavity.
- the endoscope includes an elongated and flexible insertion portion, and by inserting the insertion portion into the body cavity, examination or treatment in the body cavity can be performed.
- a bending portion is provided on the distal end side of the insertion portion.
- the bending portion is configured to perform a bending operation by connecting a plurality of bending pieces in a freely rotatable manner.
- the bending portion is bent in, for example, the up-down direction or the left-right direction by moving the operation chair connected to the bending piece constituting the bending portion back and forth.
- the operation wire moves forward and backward when the surgeon rotates the operation knob provided on the operation unit, for example, a bending knob.
- the insertion section When performing endoscopy, the insertion section must be inserted into a complicated body cavity.
- the large intestine is a complex, complicated lumen that draws a 360 ° loop.
- the surgeon When inserting the insertion portion into the large intestine, the surgeon operates the bending knob to bend the bending portion, and also performs hand operations such as twisting the insertion portion. As a result, the distal end portion of the insertion portion is introduced into the observation target portion with urgent force.
- the present invention has been made in view of the above points, and an object thereof is to provide an insertion device that can easily insert an insertion portion of a medical device such as an endoscope into a desired site. . Disclosure of the invention
- An endoscope insertion apparatus includes an insertion portion guide portion that is flexible by forming a spiral-shaped portion on an outer peripheral surface, and a guide portion that rotates the insertion portion guide portion around a longitudinal axis in a predetermined direction.
- a rotating device and a propulsive force generating device for generating a propulsive force in the longitudinal axis direction of the insertion portion guide portion with respect to the insertion portion guide portion are provided.
- FIG. 1 is a diagram illustrating the overall configuration of an endoscope system
- FIG. 2 is an external view including a partial cross-sectional view illustrating the configuration of the endoscope in the endoscope system.
- FIG. 3 is a cross-sectional view illustrating the configuration in the vicinity of the folding stop portion of the endoscope.
- FIG. 4 is a cross-sectional view illustrating the configuration of a propulsive force generating device in an endoscope system
- FIG. 5 is a diagram for explaining another configuration of the clamping unit provided in the propulsive force generating device shown in FIG.
- FIG. 6 is a diagram for explaining another configuration of the clamping unit provided in the propulsive force generation device shown in FIG.
- FIG. 7 is a diagram for explaining another configuration of the clamping unit included in the propulsive force generation device shown in FIG. 4.
- FIG. 8 is a diagram for explaining another configuration of the propulsion force generation device in the endoscope system.
- FIG. 9 is a diagram for explaining another configuration of the propulsive force generating device in the endoscope system.
- FIG. 10 is a diagram for explaining the configuration of a propulsive force generation device including an adjustment lever.
- FIG. 11 is a diagram for explaining the configuration of a propulsion generating device equipped with a stagnation generating base.
- FIG. 12 A diagram for explaining a guide tube constituted by connecting two types of guide tubes having different spiral angles.
- FIG. 13 A diagram illustrating a guide tube constructed by connecting three types of guide tubes with different spiral angles.
- FIG. 14 shows a configuration of a medical device in which a capsule type observation device is provided at the tip of a guide tube.
- an endoscope system 1 includes an endoscope 2 and an endoscope insertion aid 3.
- the endoscope 2 includes a light source device 4, a video processor 5, and a motor 6 as external devices.
- the light source device 4 is a device for supplying illumination light to the endoscope 2.
- the video processor 5 has a signal processing circuit, supplies a drive signal for driving the image pickup device built in the endoscope 2, and converts an electric signal transmitted by photoelectric conversion by the image pickup device into a predetermined image. Generate signal and output to monitor 6. An endoscopic image associated with the video signal output from the video processor 5 is displayed on the screen of the monitor 6.
- the endoscope 2 includes an insertion portion 11, an operation portion 12, and a universal cord 13.
- the endoscope insertion aid 3 includes a guide tube 21, a guide tube rotating device 22, and a propulsive force generating device 23.
- the insertion portion 11 shown in FIGS. 1 to 3 is elongated and flexible.
- a guide tube 21 serving as an insertion portion guide portion is provided that pushes the insertion portion 11 toward the deep body cavity by a propulsive force. That is, the insertion portion 11 is covered with the guide tube 21.
- a spiral-shaped portion 36 is provided on the outer peripheral surface of the guide tube 21.
- the operation unit 12 is provided on the proximal end side of the insertion unit 11.
- a guide tube rotating device 22, which is a guide rotating device, is provided in the bend preventing portion 12 a constituting the distal end side portion of the operating portion 12, or in the operating portion 12.
- the guide tube rotating device 22 includes a guide portion rotating motor (hereinafter abbreviated as a rotating motor) 39 which is a rotating means for rotating the guide tube 21 in a predetermined direction around the longitudinal axis.
- the rotation motor 39 is provided in the bend preventing portion 12 a of the operation portion 12.
- the motor 39 is a motor capable of normal rotation and reverse rotation.
- the guide tube 21 is arranged in a predetermined state on a propulsion force generator 23 installed on a bed 8 on which a patient lies, for example.
- the propulsive force generating device 23 is propulsive force generating means for generating a propulsive force for moving the guide tube 21 forward and backward in the longitudinal axis direction.
- the universal cord 13 also extends from the side portion of the operation unit 12.
- An endoscope connector 13 a connected to the light source device 4 is provided at the base end portion of the universal cord 13.
- Reference numeral 14 denotes a treatment instrument inlet, which communicates with a proximal end portion of a treatment instrument insertion channel 33 provided in the insertion section 11.
- Reference numeral 15 denotes an electric cable. One end of the electrical cable 15 is detachably connected to an electrical connector (not shown) provided on the side of the endoscope connector 13a. The other end is detachably connected to a connector (not shown) provided in the video processor 5.
- the insertion portion 11 of the endoscope 2 includes a distal end rigid portion lla, for example, a bending portion (not shown) configured to be able to bend in the vertical and horizontal directions, and a flexible tube having flexibility. Part 11c is connected and configured. As shown in FIG. 2, an illumination window 31 and an observation window 32 are provided on the distal end surface of the distal rigid portion 11a.
- the illumination window 31 constitutes an illumination optical system, and faces the tip surface of a light guide fiber (not shown) that passes through the insertion portion 11.
- the observation window 32 constitutes an observation optical system together with an image pickup device that is an image pickup means, and an optical image that has passed through the observation window 32 is provided in the image pickup device so as to form an image on an image pickup surface of a CCD, for example. It has been.
- the distal end rigid portion 11a is provided with an opening for the treatment instrument penetration channel 33.
- the rotation start switch 34a is a travel switch, and rotates the rotation motor 39 to rotate the guide tube 21 in a predetermined direction around the longitudinal axis.
- the rotation start switch 34b is a reverse switch, and rotates the rotation motor 39 in the reverse direction.
- the stop switch 35 is a switch for stopping the rotating motor 39 in the rotating state.
- a foot switch (not shown) is provided as the endoscope insertion aid 3, and the rotation motor 39 is rotated by the foot switch. Even if you control the rolling drive state.
- the guide tube 21 shown in FIG. 2 and FIG. 3 is made of, for example, stainless steel, and the metal strand 36a having a predetermined diameter is spirally wound into, for example, two layers so as to have a predetermined flexibility. It is formed.
- the degree of adhesion between the metal strands 36a wound spirally or the winding angle with respect to the insertion axis (hereinafter referred to as the spiral angle) is set. It is possible to form the guide tube 21 exhibiting a desired propulsive force by variously setting the winding angle as the adhesion degree between the metal wires 36a.
- the guide tube 21 is formed by winding a metal strand 36a from the front end to the base end in a left-handed spiral shape.
- the helical angle of the guide tube 21 is formed at a constant angle from the distal end to the proximal end.
- the guide tube 21 may be formed by forming the metal wire 36a into, for example, four strips!
- the distal end portion of the guide tube 21 is disposed on the proximal end step portion ib of the distal end rigid portion 11a.
- the proximal end portion of the guide tube 21 is integrally fixed to the distal end step portion 21b of the tubular proximal end body 21a.
- the base end main body 21a is held so as to be rotatable around the longitudinal axis by, for example, a bearing 37 provided at an opening end of the folding preventing portion 12a constituting the operation portion 12.
- a spur gear-shaped gear groove 21c is provided over the entire periphery.
- a gear 38 fixed to the motor shaft 39a of the motor 39 for rotation is engaged with the gear groove 21c provided in the base end main body 21a. Therefore, when the rotation motor 39 is driven and the motor shaft 39a rotates, the gear 38 fixed to the motor shaft 39a also rotates. Since the gear 38 is engaged with the gear groove 21c provided in the base end body 21a, the guide tube 21 provided integrally with the base end body 21a is connected to the rotation direction of the motor shaft 39a. Rotates in the opposite direction to rotate the guide tube 21. That is, when the user operates the rotation start switch 34a or 34b, the guide tube 21 is rotated in a predetermined direction. Then, when the user operates the stop switch 35, the rotation of the guide tube 21 is stopped.
- the propulsive force generating device 23 is configured to include a holding portion 42 that holds the guide tube 21 in the device main body 41.
- the clamping part 42 is constituted by an elastic member 46 provided on the upper base 43a and the lower base 43b.
- the elastic member 46 is, for example, rubber, Alternatively, it is formed of a silicon member or the like.
- the apparatus main body 41 has an upper base 43a, a lower base 43b, and a spring 44 as a pressing means.
- the upper base 43a and the lower base 43b are connected by a spring 44.
- the lower base 43b is provided with a pair of restricting members 45 that constitute restricting means for restricting the position of the guide tube 21.
- One surface of the elastic member 46 is configured as a contact plane 47 that comes into contact with the spiral-shaped portion 36 of the guide tube 21 by the pressing force of the spring 44.
- FIG. 4 a configuration in which two springs 44 are provided to connect the upper base 43a and the lower base 43b is shown, but the number of springs 44 is not limited to two. It may be more than that.
- the restricting member 45 is provided so as to prevent the guide tube 21 from being arranged to bend in the left-right direction and falling off between the elastic members 46. As a result, the guide tube 21 is in a state in which the position in the left-right direction in the figure orthogonal to the longitudinal axis direction is restricted, and the guide tube 21 can easily advance and retreat.
- the strength is set such that the hand operation to push in and the hand operation to pull back can be performed.
- the guide tube 21 may be clamped by the clamping section 42 by providing a weight on the upper base 43a. Further, instead of holding the guide tube 21 with the holding portion 42 provided at the top and bottom, the guide tube 21 is provided with the holding portion provided at the left and right. Even in a configuration that holds
- the operator prepares an endoscope 2 including a guide tube 21 disposed so as to cover the insertion portion 11 as shown in FIG. Then, as shown in FIG. 1, after the guide tube 21 is placed in the clamping portion 42 of the propulsion force generating device 23, endoscopic observation is performed from the anus of the patient lying on the bed 8 into the large intestine. Insert the distal rigid portion 11a of the endoscope 2 in the state.
- the illumination light emitted from the illumination window 31 provided in the distal rigid portion 11a illuminates the large intestine.
- the optical image in the large intestine illuminated by the illumination light is taken into the imaging device through the observation window 32, and an imaging signal photoelectrically converted by the imaging device is output to the video processor 5.
- the video processor 5 processes the image pickup signal to generate a video signal, and outputs the video signal to the monitor 6. As a result, an endoscopic image is displayed on the screen of the monitor 6.
- the surgeon determines to insert the insertion portion 11 toward the deep portion by using the propulsive force
- the surgeon is provided with the operation portion 12, and the rotation start switch 34a, which is a progression switch, is provided.
- the rotation motor 39 constituting the guide tube rotating device 22 is in a rotationally driven state, and the guide tube 21 is rotated counterclockwise about the longitudinal axis.
- the spiral-shaped part 36 of the guide tube 21 is clamped by the contact plane 47 of the elastic member 46 constituting the clamping part 42, and the spiral-shaped part 36 and the contact plane 47 are related to the male screw and the female screw. In contact. Accordingly, the guide tube 21 moves forward with respect to the longitudinal direction so that the male screw moves relative to the female screw.
- the rotation amount of the guide tube 21 generated by the propulsive force generator 23 becomes constant due to the rotation of the motor 39 for rotation. For this reason, the guide tube 21 advances in a stable state at a constant speed toward the deep part in the lumen. Then, the propulsive force of the guide tube 21 is transmitted to the distal end hard portion 11a of the insertion portion 11 covered with the guide tube 21, and the insertion portion 11 is advanced toward the deep portion in the large intestine.
- the surgeon transmits the propulsive force of the guide tube 21 and obtains the propulsive force that moves forward in the deep part of the large intestine while operating the insertion portion 11 covered with the guide tube 21 while operating the hand. Introduce deep into the large intestine. At this time, the surgeon confirms the insertion state and insertion position from the endoscopic image displayed on the screen of the monitor 6. And the content displayed on the monitor 6 If it is determined from the endoscopic image that the distal rigid portion 11a has reached the target observation site, for example, near the cecum, the operator operates the stop switch 35. Then, the rotation of the rotation motor 39 is stopped and the rotation of the guide tube 21 is stopped. Then, endoscopy in the large intestine is performed. At that time, the surgeon performs an endoscopic examination by pulling back the insertion portion 11 in a state where the guide tube 21 is covered.
- the contact portion between the spiral-shaped portion 36 of the guide tube 21 and the lumen wall also has a relationship between a male screw and a female screw. Therefore, a propulsive force that moves the guide tube 21 is also generated at the contact portion between the spiral-shaped portion 36 and the lumen wall.
- the propulsive force generated in the guide tube 21 by the propulsive force generating device 23 to move the guide tube 21 back and forth is generated between the spiral portion 36 and the lumen wall. This configuration has priority over the propulsive force generated in the contact portion.
- the insertion portion 11 including the guide tube 21 is inserted into the body cavity.
- the guide tube 21 provided so as to cover the insertion portion 11 is clamped by the contact plane 47 of the elastic member 46 constituting the clamping portion 42 provided in the propulsive force generating device 23.
- the spiral-shaped portion 36 and the abutting plane 47 are in a relationship between a male screw and a female screw.
- the rotation start switch 34a or the rotation start switch 34b is operated. Then, the guide tube 21 is rotated in the direction corresponding to the switch operation.
- the propulsive force generating device 23 constituting the endoscope system 1 of the present embodiment has a simple structure and does not require electric power or the like, so that it can be configured at a low cost. And since the structure is simple, the washability is good. Moreover, since it is an inexpensive configuration, it can be made disposable.
- a guide tube rotating device 22 for rotating the guide tube 21 is built in the operation unit 12 constituting the endoscope 2 or the like.
- the guide tube rotating device 22 may be provided outside the endoscope 2. In this configuration, the guide tube rotating device 22 provided outside rotates the guide tube 21 disposed so as to cover the insertion portion 11.
- the holding member 42 of the propulsive force generating device 23 is configured by providing the elastic member 46 having the abutting plane 47 that contacts the helically shaped portion 36 of the guide tube 21.
- the configuration of the clamping portion provided in the propulsion force generator 23 is not limited to this, and may be the configuration shown in FIGS. 5 to 7 shown below.
- the clamping portion 42B is composed of a resilient member 46 having a contact plane 47 and an elastic member 46b having a regulating surface 48 which is a pair of regulating means.
- the regulating surface 48 is formed as a concave portion having an inverted V-shaped cross section that opens to the abutting plane 47 side of the elastic member 46 provided on the lower base 43b.
- the elastic member 46 that constitutes the holding portion 42B and the regulating surface 48 are provided.
- the guide tube 21 is inserted and disposed between the elastic member 46b and the elastic member 46b against the pressing force of the spring 44. Then, the contact plane 47 of the elastic member 46 and the regulating surface 48 are bitten into the spiral-shaped portion 36 of the guide tube 21, and the relationship between the male screw and the female screw is established. For this reason, in this embodiment, the position of the guide tube 21 can be regulated without providing the regulating member 45 as the regulating means.
- Other configurations are the same as those of the above-described embodiment, and according to this configuration, the same operations and effects as those of the above-described embodiment can be obtained.
- an elastic member 46b having a regulating surface 48 formed of a V-shaped recess is provided on the upper base 43a.
- the elastic member 46b having the restricting surface 48 may be provided on the lower base 43b, or the elastic member 46b having the restricting surface 48 may be provided on the upper base 43a and the lower base 43b.
- the restricting surface 48 is provided on the elastic member 46b of the clamping portion 42B, and the restricting surface 48 and the contact flat surface 47 of the elastic member 46 are brought into contact with the spiral-shaped portion 36 of the guide tube 21.
- the position of the guide tube 21 can be reliably regulated.
- Other operations and effects are the same as those of the above-described embodiment.
- the clamping portion 42C is constituted by a pair of elastic members 46c.
- Each elastic member 46c is provided with a recess 49 which is a U-shaped restricting means for preventing the guide tube 21 from falling off.
- the bottom surface of the recess 49 is configured as a contact plane 47.
- Each elastic member 46c is fixed to the upper base 43a and the lower base 43b so that the openings of the recess 49 face each other.
- the guide tube 21 is inserted and disposed between the concave portions 49 of the elastic member 46c constituting the clamping portion 42C against the pressing force of the spring 44. Then, the substantially outer periphery of the spiral-shaped portion 36 of the guide tube 21 is surrounded by the pair of recesses 49, and the position of the guide tube 21 is regulated. At this time, since the bottom surface of the concave portion 49 provided in the elastic member 46c is configured as the contact plane 47, the corresponding contact plane 47 bites into the spiral-shaped portion 36 and has a relationship between a male screw and a female screw. That is, also in this embodiment, the position of the guide tube 21 without the provision of the restricting member 45 as the restricting means can be restricted.
- the opening of the recess 49 may be set wider than the diameter of the guide tube 21 so that the guide tube 21 is loosely fitted in the width direction of the recess 49. This makes it possible to easily insert and remove the guide tube 21 with respect to the elastic member 46c.
- the clamping portion 42D has an L-shaped elastic member 55 having a L-shaped cross section and a prismatic shape, and a regulating surface that constitutes a regulating means at one ridge line A pressing elastic member 52 provided with 48.
- the L-shaped elastic member 55 is provided at a predetermined portion of the base body 41d provided with the support column 51 having the arm portion 51a.
- the two surfaces of the L-shaped elastic member 55 are configured as a pair of contact planes 47 that also serve as a restricting means.
- the pressing elastic member 52 is screwed and fixed, for example, in a predetermined state to the distal end portion of the rod-like portion 54 disposed in the arm portion 51a.
- the rod-like portion 54 is provided with a spring 56 for urging the pressing elastic member 52 with a predetermined urging force in the direction of the arrow in the drawing.
- the rod-like portion 54 is provided with a handle portion 53 used when the pressing elastic member 52 is moved in the direction opposite to the arrow against the urging force of the spring 56.
- the handle portion 53 is integrally provided at the end of the rod-like portion 54, for example.
- the regulation surface 48 and the pair of contact planes 47 bite into the spiral-shaped portion 36 of the guide tube 21 so that a relationship between the male screw and the female screw is obtained. That is, also in this embodiment, the position of the guide tube 21 can be regulated without providing the regulating member 45 as the regulating means.
- Other configurations are the same as those of the above-described embodiment, and according to this configuration, the same operations and effects as those of the above-described embodiment can be obtained.
- a second embodiment of the present invention will be described with reference to FIG.
- the configuration of the propulsive force generating device 23E constituting the endoscope system 1 is different from the first embodiment described above.
- the propulsive force generators 23, 23B, 23C, 23D according to the first embodiment described above are provided with the clamps 42, 42B, 42C, 42D.
- the guide tube 21 is sandwiched by the clamping portions 42, 42B, 42C, and 42D to form a relationship between the male screw and the female screw, and a propulsive force in the longitudinal axis direction is generated in the guide tube 21 by the action of the screw.
- a through hole 61a or a slit into which the guide tube 21 is inserted is formed in the convex portion 61 of the device main body 23e, and each opening of the through hole 61a is formed.
- a flexible member 62 is provided at the end. The flexible member 62 is provided with an abutting end portion 62a disposed in contact with the outer surface of the guide tube 21.
- the propulsive force generating device 23E has a device body 23e having a reverse T-shaped cross section.
- the projecting portion 61 of the apparatus main body 23e is provided with a through hole 6la.
- a guide tube 21 is disposed through the through hole 61a.
- a flexible member 62 having a hole is disposed at a predetermined position on both opening sides of the through hole 61a.
- the end of the hole is configured as a contact end 62a.
- the flexible member 62 is made of, for example, silicon, which is thinner than the elastic member of the first embodiment.
- the guide tube 21 is disposed in the propulsive force generating device 23E through the hole of one flexible member 62, the through hole 61a provided in the apparatus main body 23e, and the hole of the one flexible member 62.
- the contact end portion 62a of the flexible member 62 contacts the spiral-shaped portion 36 of the guide tube 21 to hold the guide tube 21.
- the contact state between the spiral-shaped portion 36 and the contact end portion 62a of the flexible member 62 becomes the relationship between the male screw and the female screw. Therefore, also in the present embodiment, a propulsive force is applied to the guide tube 21 by the action of the screw.
- the spiral-shaped portion 36 of the guide tube 21 is formed on the inner peripheral surface of the through hole 61a. It is arranged without contact. That is, the through hole 61a is formed with a predetermined diameter and a larger diameter than the outer diameter of the guide tube 21. Further, the holding force of the flexible member 62 that holds the spiral-shaped portion 36 of the guide tube 21 is smaller than the force that the holding portion 42 of the first embodiment holds the guide tube 21. Therefore, the surgeon can easily push and pull the guide tube 21. [0050] The operation of the endoscope system 1 including the propulsive force generator 23E configured as described above will be described.
- the surgeon prepares an endoscope 2 having a guide tube 21 that covers the insertion portion 11. Then, with the guide tube 21 placed in the through hole of the propulsive force generating device 23E, the endoscope 2 is in an endoscopic observation state from the anus of the patient lying on the bed into the large intestine. Insert the tip of.
- the surgeon determines that the insertion portion 11 is to be inserted deeply by the propulsive force
- the surgeon operates the rotation activation switch 34a provided in the operation portion 12 to rotate the rotation motor 39.
- the guide tube 21 is then rotated counterclockwise about the longitudinal axis.
- the spiral-shaped portion 36 of the guide tube 21 and the abutting end portion 62a of the flexible member 62 sown in the propulsive force generating device 23E are in contact with each other due to the relationship between the male screw and the female screw.
- Propulsive force that moves with respect to the female screw is generated, and the guide tube 21 advances in the longitudinal direction.
- the same operation as in the first embodiment described above can be obtained.
- the endoscope system according to the second embodiment can obtain the same effects as those of the first embodiment.
- the contact state of the contact end 62a with respect to the spiral-shaped portion 36 can be changed by appropriately setting the diameter of the hole formed in the flexible member 62. Therefore, setting and control of the clamping force becomes easier, and the propulsion amount can be stabilized. Further, since the configuration of the flexible member 62 and the like is simple, the manufacturing becomes easy and the configuration is inexpensive.
- FIG. 8 shows a configuration in which one flexible member 62 is disposed on each end opening side of the through hole 6 la of the apparatus body 23e.
- the configuration is not limited to this configuration, and the flexible member 62 is not limited to this configuration.
- a configuration in which only one sheet is provided on one opening side, or a structure in which a plurality of flexible members are provided on at least one opening side in consideration of the pitch of the spiral portion 36 may be employed.
- the propulsive force generating device 23 presses the elastic member against the spiral-shaped portion 36 of the guide tube 21 or abuts the flexible member to contact the spiral-shaped portion 36 with the elastic member.
- the contact portion between the spiral-shaped portion 36 and the flexible member has a relationship between a male screw and a female screw, and a propulsive force is generated in the guide tube 21 by the action of the screw.
- the weight of the insertion portion 11 and the guide tube 21 acting vertically downward is converted into propulsive force.
- the propulsive force generating device 23F constituting the endoscope system 1 of the present embodiment is configured in a chair shape by providing the device main body 41f with an inclined portion 71 and a horizontal portion 72. Therefore, the guide tube 21 arranged in the apparatus main body 41f is bent.
- the device body 41f, the inclined portion 71, and the horizontal portion 72 are formed of metal, blast, or the like.
- the inclined portion 71 generates a propulsive force in the longitudinal axis direction by converting its own downward weight to a propulsive force in the longitudinal axis direction with respect to the insertion portion 11 covered with the guide tube 21.
- the horizontal portion 72 is a support portion that supports the guide tube 21 provided with the propulsive force in the longitudinal axis direction by the inclined portion 71 in the horizontal direction.
- the guide tube 21 covering the insertion portion 11 is disposed on the inclined portion 71 and the horizontal portion 72 of the propulsive force generating device 23F. At this time, the surgeon relaxes and holds the guide tube 21 positioned between the propulsive force generating device 23F and the patient. Further, the insertion portion 11 and the guide tube 21 are arranged so that the weight of the insertion portion 11 and the guide tube 21 is applied to the inclined portion 71. Then, in the inclined portion 71 of the propulsive force generating device 23F, a force F that is a propulsive force by a reaction force is generated from the inclined portion 71 against the weight of the insertion portion 11 and the guide tube 21 due to the action of gravity.
- a force F that advances in the horizontal direction acts on the insertion portion 11 and the guide tube 21.
- the insertion portion 11 and the guide tube 21 always have a propulsive force due to the reaction force from the inclined portion 71. It is given stably. Therefore, when the distal end rigid portion 11a of the endoscope 2 is inserted into the patient's anal force large intestine with the guide tube 21 placed on the propulsion force generating device 23F, the operator can insert the insertion portion 11 and the guide tube 21.
- the propulsive force imparted to the auxiliary member assists the advancement of the insertion portion 11 so that the insertion portion 11 can be easily inserted toward the deep portion.
- the rotation motor 39 of the guide tube rotating device 22 is driven to rotate so that the guide tube 21 is moved in a predetermined direction around the longitudinal axis. Rotate. Then, the contact portion between the spiral-shaped portion 36 and the inner wall of the lumen becomes the male screw and the female screw. Therefore, a propulsive force due to the action of the screw is generated in the guide tube 21. As a result, the insertion portion 11 is advanced more smoothly.
- the guide tube 21 covering the insertion portion 11 is arranged on the inclined portion 71, the weight of the insertion portion 11 and the guide tube 21 is converted into a propulsive force, and the insertion portion 11 is moved into the body cavity. Propulsion when inserting can be obtained.
- the guide tube 21 is loosely held and arranged so that the weight of the guide tube 21 is exerted on the inclined portion 71 of the propulsive force generating device 23F, regardless of the diameter of the guide tube 21. A constant driving force can always be obtained.
- the guide tube 21 is not clamped by the elastic member, so the elastic member does not wear.
- the medical device disposed in the propulsive force generation device 23F is not limited to the guide tube that covers the insertion portion of the endoscope as described above, but, for example, a treatment tool provided in the insertion portion of the endoscope It may be a narrow guide tube or the like inserted into the insertion channel.
- an elastic sheet member may be attached to the surfaces of the inclined portion 71 where the guide tube 21 is disposed and the horizontal portion 72.
- the contact portion between the helically shaped portion 36 of the guide tube 21 and the elastic sheet member is in a relationship between a male screw and a female screw. Therefore, when the guide tube 21 is rotated, in addition to the propulsive force obtained by the inclined portion 71, it is possible to obtain the propulsive force due to the action of the screw.
- a restricting member (not shown) for restricting the position of the guide tube 21 may be provided on at least one of the inclined portion 71 and the horizontal portion 72 of the propulsive force generating device 23F. As a result, the guide tube 21 is arranged without being displaced.
- the thrust generating device 23G may be configured by providing an adjustment lever 73 that enables adjustment of the bending angle formed by the inclined portion 71 and the horizontal portion 72.
- the propulsive force generator 23G shown in the figure is provided with an adjustment lever 73 for adjusting the bending angle formed by the inclined portion 71 and the horizontal portion 72, in other words, the inclination angle of the inclined portion 71b. Therefore, the inclination angle of the inclined portion 71b can be adjusted to a desired angle. This makes it possible to adjust the propulsive force applied to the guide tube 21 to a desired state when the propulsive force generator 23G is arranged.
- the propulsion generator 23H may be configured by providing In the propulsive force generating device 23H shown in the figure, a stagnation generating base 74 is provided at a predetermined position of the horizontal portion 72 so that the guide tube 21 is put in a desired state.
- the stagnation generating base 74 is set to a predetermined height dimension, and is provided on the guide pipe arrangement surface side of the horizontal portion 72 so as to be fixed or movable.
- the guide tube 21 by placing the guide tube 21 on the propulsion force generating device 23H and making the guide tube 21 bend, the force A and the force F due to the restoring force that the guide tube 21 tries to return to the linear state are generated by the guide tube 21. Granted as a driving force to advance 21. As a result, the propulsive force applied to the guide tube 21 increases.
- the spiral angle of the spiral-shaped portion 36 is constant.
- the guide tube 80 shown in FIG. 12 includes a first guide tube 80a having a helical angle ⁇ with respect to the insertion axis, a second guide tube 80b having a helical angle ⁇ with respect to the insertion axis, and a first guide tube 80a. And a pipe-shaped connecting member 81 that connects the second guide pipe 80b.
- the connection member 81 is a metal such as stainless steel or a flexible member such as rubber, and is fixed integrally by soldering or bonding.
- the first guide tube 80a is provided on the insertion direction side
- the second guide tube 80b is provided on the proximal end side to constitute the guide tube 80.
- the spiral angle ex and the spiral angle ⁇ are set to ⁇ ⁇ .
- the second guide tube 80b is larger than the tube 80a. For this reason, a pressing force (propulsive force) is always applied to the first guide tube 80a side (insertion direction side).
- the guide tube 80 moves toward the insertion direction when the first guide tube 80a, which is the tip side of the propulsion generating device, is stuck or does not squeeze well.
- the pulling force and idling are released by the pushing force, and stable insertion into the body cavity becomes possible.
- the propulsion speed can be set arbitrarily.
- the spiral angle of the guide tube inserted into the body cavity and the spiral angle of the guide tube disposed outside the body are set to different angles.
- the guide tube 90 includes an in-vivo guide tube 90a to be inserted into the body cavity, a first in-vivo guide tube 90b and a second in-vivo guide tube 90c arranged outside the body, and a connection member 81. Configured. In the external portion of the internal tube 90, the first external guide tube 90b and the second external guide tube 90c are alternately connected by the connecting member 81.
- the body cavity guide tube 90a has a helical angle ⁇ with respect to the insertion axis.
- the first extracorporeal guide tube 90b has a helical angle p with respect to the insertion axis.
- the second extracorporeal guide tube 90c has a helical angle with respect to the insertion axis.
- the relationship between the spiral angles of the body cavity guide tubes 90a, 90b, 90c is set to ⁇ ⁇ ⁇ ⁇ p.
- the spiral angle y of the body cavity guide tube 90a inserted into the body cavity is medium, and the spiral angle p of the first body guide tube 90b disposed in the extracorporeal part is large.
- the helical angle of the extracorporeal guide tube 90c; z is set small. According to the guide tube 90 having this configuration, the propulsive force (propulsion amount) can be changed, and the spiral angle of each guide tube is the propulsive force changing means.
- the guide tube 90 is inserted into the body cavity with a moderate amount of propulsion. Thereafter, the first extracorporeal guide tube 90b and the second extracorporeal guide tube 90c are alternately arranged with respect to the thrust generating device.
- the first external guide tube 90b is disposed with respect to the propulsive force generating device, a large propulsive force is applied to the internal tube 90, and when the second external guide tube 90c is disposed, the guide tube 90 is small. Propulsion is given.
- the first external guide tube 90b and the second external guide tube 90c for the outside of the body are alternately arranged on the propulsion generator, so It is possible to insert into the body cavity by alternately repeating the propulsion amount.
- the present embodiment is not limited to the configuration in which the insertion portion 11 is covered with the guide tube 21, but for example, a capsule endoscope provided at the tip of the guide tube 21 having the spiral-shaped portion 36, or an endoscope It may be a guide tube or the like that is used by being inserted into the mirror treatment tool penetration channel.
- Figure 14 shows the observation device.
- the observation device 91 shown in the figure is provided with a capsule 92 on the distal end side of the guide tube 21 having the spiral-shaped portion 36.
- the capsule 92 incorporates an imaging device that constitutes an illumination optical system and an imaging optical system.
- a signal cable or the like extending through the imaging device force is inserted.
- the observation device 91 is rotated in a predetermined direction around the longitudinal axis by a guide tube rotation device (not shown) provided separately or integrally with the observation device 91. .
- the observation device 91 obtains a propulsive force in the longitudinal axis direction by the propulsive force generating device and is inserted toward the deep part of the body cavity. ing. In addition, the observation device 91 can be moved backward by reversing the rotation motor of the guide tube rotation device. Note that a signal cable is not required by making the capsule 92 a wireless communication type.
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Biomedical Technology (AREA)
- Medical Informatics (AREA)
- Optics & Photonics (AREA)
- Pathology (AREA)
- Radiology & Medical Imaging (AREA)
- Biophysics (AREA)
- Engineering & Computer Science (AREA)
- Physics & Mathematics (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Instruments For Viewing The Inside Of Hollow Bodies (AREA)
- Endoscopes (AREA)
Abstract
Description
Claims
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP2006537654A JP4365865B2 (ja) | 2004-09-28 | 2005-08-30 | 挿入装置 |
US11/728,484 US20070173093A1 (en) | 2004-09-28 | 2007-03-26 | Insertion device |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP2004282423 | 2004-09-28 | ||
JP2004-282423 | 2004-09-28 |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US11/728,484 Continuation US20070173093A1 (en) | 2004-09-28 | 2007-03-26 | Insertion device |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2006035566A1 true WO2006035566A1 (ja) | 2006-04-06 |
Family
ID=36118718
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/JP2005/015775 WO2006035566A1 (ja) | 2004-09-28 | 2005-08-30 | 挿入装置 |
Country Status (3)
Country | Link |
---|---|
US (1) | US20070173093A1 (ja) |
JP (1) | JP4365865B2 (ja) |
WO (1) | WO2006035566A1 (ja) |
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2009050557A (ja) * | 2007-08-28 | 2009-03-12 | Olympus Medical Systems Corp | 回転自走式内視鏡システム |
WO2017014308A1 (ja) * | 2015-07-23 | 2017-01-26 | オリンパス株式会社 | マニピュレータ及び医療システム |
Families Citing this family (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE102012110766A1 (de) * | 2012-11-09 | 2014-05-15 | MAQUET GmbH | Instrumentenhalter zum Befestigen eines medizinischen Instrumentes an einem Gelenkarm |
KR102297070B1 (ko) * | 2018-04-12 | 2021-09-02 | 한국과학기술원 | 자율 주행 내시경 시스템 및 그 제어 방법 |
WO2019199125A1 (ko) | 2018-04-12 | 2019-10-17 | 주식회사 이지엔도서지컬 | 자율 주행 내시경 시스템 및 그 제어 방법 |
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- 2005-08-30 JP JP2006537654A patent/JP4365865B2/ja not_active Expired - Fee Related
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2007
- 2007-03-26 US US11/728,484 patent/US20070173093A1/en not_active Abandoned
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JPS54160083A (en) * | 1978-06-07 | 1979-12-18 | Hattori Norikazu | Retractor of coeliac mirror*such as* colon fiberrscope*etc* |
JPS5542657A (en) * | 1978-09-22 | 1980-03-26 | Medos Kenkyusho Kk | Coelom inside induction device in endoscope* etc* |
JPS5545426A (en) * | 1978-09-25 | 1980-03-31 | Medos Kenkyusho Kk | Coelom inside induction device in endoscope* etc* |
JPH0397431A (ja) * | 1989-09-08 | 1991-04-23 | Olympus Optical Co Ltd | 内視鏡装置 |
JPH10113396A (ja) * | 1996-10-14 | 1998-05-06 | Takeshi Ikeuchi | 医療機器の推進装置 |
JP2000107123A (ja) * | 1998-10-05 | 2000-04-18 | Olympus Optical Co Ltd | 内視鏡挿入装置 |
Cited By (7)
Publication number | Priority date | Publication date | Assignee | Title |
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JP2009050557A (ja) * | 2007-08-28 | 2009-03-12 | Olympus Medical Systems Corp | 回転自走式内視鏡システム |
WO2017014308A1 (ja) * | 2015-07-23 | 2017-01-26 | オリンパス株式会社 | マニピュレータ及び医療システム |
JP6177488B2 (ja) * | 2015-07-23 | 2017-08-09 | オリンパス株式会社 | マニピュレータ及び医療システム |
JPWO2017014308A1 (ja) * | 2015-07-23 | 2017-09-28 | オリンパス株式会社 | マニピュレータ及び医療システム |
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CN107847110B (zh) * | 2015-07-23 | 2019-11-08 | 奥林巴斯株式会社 | 操纵器和医疗系统 |
US10932875B2 (en) | 2015-07-23 | 2021-03-02 | Olympus Corporation | Manipulator, medical system, and medical system control method |
Also Published As
Publication number | Publication date |
---|---|
JPWO2006035566A1 (ja) | 2008-05-15 |
JP4365865B2 (ja) | 2009-11-18 |
US20070173093A1 (en) | 2007-07-26 |
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