WO2013132861A1 - Outil de protection de région et endoscope comprenant l'outil de protection de région - Google Patents

Outil de protection de région et endoscope comprenant l'outil de protection de région Download PDF

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Publication number
WO2013132861A1
WO2013132861A1 PCT/JP2013/001455 JP2013001455W WO2013132861A1 WO 2013132861 A1 WO2013132861 A1 WO 2013132861A1 JP 2013001455 W JP2013001455 W JP 2013001455W WO 2013132861 A1 WO2013132861 A1 WO 2013132861A1
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WO
WIPO (PCT)
Prior art keywords
main body
endoscope
extension
cross
hollow space
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PCT/JP2013/001455
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English (en)
Japanese (ja)
Inventor
宏仁 森
Original Assignee
国立大学法人香川大学
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Publication of WO2013132861A1 publication Critical patent/WO2013132861A1/fr

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    • 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
    • A61B1/00064—Constructional details of the endoscope body
    • A61B1/00071—Insertion part of the endoscope body
    • A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
    • 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
    • A61B1/00131—Accessories for endoscopes
    • A61B1/00135—Oversleeves mounted on the endoscope prior to insertion
    • 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
    • A61B1/00131—Accessories for endoscopes
    • A61B1/00137—End pieces at either end of the endoscope, e.g. caps, seals or forceps plugs
    • 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
    • A61B1/00154—Holding or positioning arrangements using guiding arrangements for insertion

Definitions

  • the present invention relates to an area securing instrument and an endoscope including the area securing instrument. More specifically, it is used for transluminal endoscopic surgery in which a through-hole is formed in the digestive tract by an endoscope inserted into the digestive tract cavity such as the mouth, anus, or vagina, or in the abdominal cavity.
  • the present invention relates to a region securing instrument and an endoscope provided with the instrument.
  • Transluminal endoscopic surgery (hereinafter referred to as NOTES) is a procedure that removes lesions in the digestive tract cavity or abdominal cavity using an endoscope inserted into the digestive tract cavity such as the mouth, anus, or vagina. Surgery to perform.
  • a hood with an open tip that is attached to the tip of the endoscope and used as an instrument for surgery that does not allow a through-hole in the stomach Have also been developed (Patent Documents 1 and 2).
  • Patent Documents 1 and 2 When such a hood is provided, a space can be formed between the distal end of the endoscope and the stomach wall by the hood, so that the stomach wall and the like can be easily observed. Further, if the affected part or the like is positioned in the distal end opening of the hood, the affected part can be separated from the distal end of the endoscope to some extent, so that the affected part can be easily treated with the endoscope.
  • the hoods disclosed in Patent Documents 1 and 2 are used by being fixed to the tip of the endoscope, and the visual field that can be secured by such a hood is at most about the diameter of the endoscope, that is, The diameter and depth are only about 2 cm. For this reason, it is difficult to secure a sufficient visual field and operative field for NOTES. Moreover, even if a hood for the endoscope is provided, if the stomach wall becomes deflated during surgery to remove the stomach wall, the stomach wall on the front of the hood will be folded even if there is a hood. It is difficult to secure a sufficient visual field and surgical field for surgery. And, when performing surgery by invading the distal end of the endoscope into the abdominal cavity from the hole formed in the stomach wall, a larger visual field and surgical field are required, so just providing a hood as described above, It is impossible to perform surgery.
  • NOTES does not use a lifting method that fixes the stomach wall to the abdominal wall, in other words, a method for securing a visual field and an operating field for surgery without forming a wound on the body surface.
  • a lifting method that fixes the stomach wall to the abdominal wall
  • a method for securing a visual field and an operating field for surgery without forming a wound on the body surface has not been developed, and there is a strong demand for the development of such technology.
  • an object of the present invention is to provide an area securing instrument and an endoscope provided with an area securing instrument capable of securing a visual field and a surgical field of a surgical site in NOTES.
  • An area securing instrument is an area securing instrument used for transluminal endoscopic surgery, and has a cylindrical main body having a hollow space.
  • the hollow space of the main body can be expanded and contracted in a direction intersecting the central axis of the hollow space.
  • the cross-sectional area of the hollow space of the main body portion is larger than the cross-sectional area of the shaft of the endoscope. It is formed so that it may become large.
  • the region securing instrument according to the first aspect wherein the main body portion is substantially cylindrical when contracted, and in a magnified state, the cross-sectional area of the hollow space at the proximal end portion is internally viewed.
  • the cross-sectional area of the mirror shaft is larger, and the cross-sectional area of the hollow space at the distal end is larger than the cross-sectional area of the hollow space at the proximal end.
  • the region securing instrument of the third invention is the first or second invention, when a force of a certain level or more is applied in a direction from the direction in which the main body portion intersects the central axis of the hollow space toward the central axis. It is characterized in that it is contracted so that its cross-sectional area becomes small and is adjusted so that it can return to its original shape when the force is removed.
  • a region securing device is a region securing device used for transluminal endoscopic surgery, and includes a main body portion formed so that a cross-sectional area of a distal end portion thereof can expand and contract.
  • the main body portion includes a cylindrical support portion having a hollow space, and a region holding portion having a base end coupled to the support portion, and the support portion has an internal cross-sectional area. It is formed so as to be larger than the cross-sectional area of the shaft of the endoscope, and the region holding portion has a plurality of region holding pieces provided along the circumferential direction of the support portion.
  • the tip of the piece is provided so as to be able to approach and separate from the central axis direction of the support portion, and is formed by the tips of the plurality of region holding pieces in a state of being separated from the central axis of the support portion.
  • the cross-sectional area of the space is formed so as to be larger than the cross-sectional area of the support portion.
  • the region securing device according to a fifth aspect of the present invention is the region securing tool according to the fourth aspect, wherein each region holding piece has a certain force in a direction from the direction intersecting the central axis of the support portion toward the central axis with respect to the tip.
  • the area securing device is the invention according to any one of the first to fifth aspects, wherein the region securing device includes a cylindrical connecting pipe having a hollow space, and the connecting pipe is the hollow
  • the cross-sectional area of the space is larger than the cross-sectional area of the shaft of the endoscope, and the tip of the space is communicated with the hollow space of the main body. It is connected with the base end of this main-body part, It is characterized by the above-mentioned.
  • the area securing instrument according to a seventh aspect of the present invention is the invention according to any one of the first to sixth aspects, wherein an extension portion is provided in the main body portion so as to be able to protrude and retract from the tip of the main body portion.
  • the main body of the first, second, third, fourth or fifth invention has substantially the same shape and is accommodated in the main body so as to be movable along the central axis direction of the main body. It is characterized by.
  • there is provided the region securing instrument according to the seventh aspect wherein a plurality of the extension portions are provided in the main body portion, and the plurality of extension portions have different cross-sectional areas at the distal end portion in the contracted state.
  • An extension portion having a smaller cross-sectional area of the tip portion in a contracted state than the one extension portion is accommodated in the one extension portion, and is provided so as to be movable along the axial direction.
  • the extension portion accommodated in the extension portion is provided so as to be able to protrude and retract from the tip of the one extension portion.
  • the region securing instrument according to a ninth aspect of the present invention is the seventh or eighth aspect of the invention, wherein the extension portion has a cross-sectional area of the tip portion in an enlarged state, and the extension portion that accommodates the main body portion and the extension portion is enlarged. In this state, the cross-sectional area of the tip portion is formed to be small.
  • a region securing instrument is the tube having a hollow space provided in the connecting pipe and movably along the axial direction of the connecting pipe in the seventh, eighth or ninth invention.
  • the extension connecting pipe is formed such that the cross-sectional area of the hollow space is larger than the cross-sectional area of the shaft of the endoscope, and the hollow space is the extension pipe.
  • the tip is connected to the base end of the main body so as to communicate with the hollow space of the part.
  • An endoscope provided with a region securing instrument according to an eleventh aspect of the invention is an endoscope used for transluminal endoscopic surgery, and the endoscope has a shaft inserted through the endoscope.
  • the area securing instrument according to any one of the first to tenth aspects of the invention is provided, and the area securing instrument is inserted into the outer cylinder and the outer cylinder.
  • the main body portion is disposed so as to be able to protrude from the distal end of the outer tube along the axial direction of the shaft of the endoscope. It is characterized by.
  • An endoscope having a region securing instrument according to a twelfth aspect of the present invention is the endoscope according to the eleventh aspect, wherein the connecting tube and / or the extended connecting tube is connected to the main body portion and / or the extended portion.
  • the length from the distal end of the main body and / or the extension in the axial direction of the connecting pipe and / or the extended connecting pipe to the base end of the connecting pipe and / or the extended connecting pipe is the axial direction of the outer cylinder It is characterized by being formed so as to be longer than the length.
  • the main body is disposed at the distal end of the outer cylinder through which the endoscope is inserted, and the main body protrudes from the distal end of the outer cylinder and is enlarged, It is possible to secure a field of view for an endoscope and a surgical field for an operation using an endoscope.
  • the main body portion is formed to a size that can be accommodated in the outer cylinder when contracted, the main body portion can be moved to a place where surgery or the like is performed while being accommodated in the outer cylinder. It becomes easy to arrange the main body at a place where surgery is performed.
  • the main body if the main body is in an enlarged state, a space that expands from the base end toward the tip can be formed in the main body. Then, counter traction and triangulation can be performed on the collapsed stomach and the like. In addition, since a wide surgical field can be ensured at a position close to the outer cylinder, an effect of facilitating the operation in the near field can be obtained.
  • the main body when the contracted main body is accommodated in the distal end of the outer cylinder through which the endoscope is inserted, the main body can be simply projected from the distal end of the outer cylinder. The portion can be enlarged.
  • the main body portion contracts, so that the main body portion can be accommodated in the outer cylinder. That is, the main body can be expanded and contracted simply by projecting the main body from the front end of the outer cylinder or by pushing or pulling the main body from the front end of the outer cylinder. Therefore, since a special mechanism for expanding and contracting the main body is not necessary, the structure of the instrument can be simplified.
  • the region holding portion The field of view of the endoscope and the surgical field for the operation by the endoscope can be secured.
  • the main body is formed in a size that can be accommodated in the outer cylinder when the distal end of the region holding portion is brought close to the central axis of the support section, the main body is operated in a state of being accommodated in the outer cylinder. Therefore, it is easy to place the main body at the place where surgery is performed.
  • region holding part shall be in the state spaced apart from the center axis
  • tip part from a base end part can be formed in a main-body part. Then, counter traction and triangulation can be performed on the collapsed stomach and the like.
  • a wide surgical field can be ensured at a position close to the outer cylinder, an effect of facilitating the operation in the near field can be obtained.
  • the main body with the distal end of the region holding portion approaching the central axis of the support is accommodated in the distal end of the outer cylinder through which the endoscope is inserted, the main body By merely projecting from the tip of the outer cylinder, the tip of the region holding part can be separated from the central axis of the support part. On the contrary, if the main body is pushed into or retracted from the front end of the outer cylinder, the front end of the region holding section can be brought closer to the central axis of the support section, so that the main body is accommodated in the outer cylinder. can do.
  • the front end portion of the region holding portion is moved closer to and away from the central axis of the support portion simply by projecting the main body portion from the front end portion of the outer cylinder or by pushing or pulling in the inner end from the front end portion of the outer cylinder be able to.
  • the proximal end of the connecting pipe is operated if the area securing instrument is placed in the outer cylinder so that the main body is positioned at the distal end of the outer cylinder through which the endoscope is inserted.
  • the main body portion can be moved along the axial direction of the outer cylinder, and the main body section can be projected and retracted from the tip of the outer cylinder.
  • the extension part protrudes from the main body part, the stomach wall, the organ, etc. hanging from the front surface of the main body part can be lifted. Then, compared with the case where the area is secured only by the main body, a wider area can be secured in the axial direction of the outer cylinder, that is, in the depth direction of the field of view of the endoscope.
  • the visual field region can be moved in the axial direction of the outer cylinder while securing a visual field region of a certain level or more. Then, when the endoscope is moved while searching for an affected part in a deflated stomach or abdominal cavity, the affected part can be easily found.
  • the eighth invention since there are a plurality of extensions, it becomes easier to secure a wider area in the depth direction of the field of view of the endoscope, and the endoscope can be used while searching for the affected part in a deflated stomach or abdominal cavity. When moving, the endoscope is easily moved.
  • the extension portion having the smallest cross-sectional area is located at the tip, it is easy to enter the organ or the deflated stomach. And if it is an area
  • the extension portion by operating the base end of the extension connecting pipe, the extension portion can be projected and retracted from the distal end of the main body portion or another extension portion.
  • the connecting pipe and / or the extension connecting pipe By manipulating the base end, the main body part and / or the extension part can be moved along the axial direction of the outer cylinder, and the main body part and / or the extension part can be projected and retracted from the distal end of the outer cylinder. This eliminates the need for a special mechanism for causing the main body part and / or the extension part to protrude from the tip of the outer cylinder, so that the structure of the instrument can be simplified.
  • FIG. 2A is a sectional view taken along line IIA-IIA in FIG. 1
  • FIG. 2B is a partial cross-sectional view taken along line BB in FIG.
  • FIG. 2B is a schematic explanatory drawing of the state by which the main-body part 11 of the instrument 10 for area
  • FIG. It is a schematic explanatory drawing of the condition which is using the endoscope 1 provided with the instrument 10 for area
  • (A) is the state in which the main-body part 11 is accommodated in the outer cylinder 5.
  • FIG. It is a schematic explanatory drawing of the condition arrange
  • (B) is explanatory drawing of the state which made the main-body part 11 protrude from the outer cylinder 5 tip from the state of (A), and was expanded.
  • (C) is a schematic explanatory drawing of the state which bent the endoscope 1 from the state of (B). It is the figure which showed an example of the operation by NOTES. It is a schematic explanatory drawing of the instrument 10 for area
  • FIG. 3 is a schematic explanatory view of the region securing instrument 10 of the present embodiment in a state where the extension portion 21 is accommodated in the main body portion 11, and (A) a schematic explanatory view of the outer cylinder 5 viewed from the axial direction.
  • (B) is a partial cross-sectional view taken along line BB of (A). It is a schematic explanatory drawing of the state which has lifted stomach wall ST by the main-body part 11 and the extension part 21.
  • the region securing instrument of the present invention is an instrument used in transluminal endoscopic surgery (hereinafter referred to as NOTES) using an endoscope, without complicating the structure of the endoscope. It is characterized by the fact that the field of view and the surgical field for surgery can be secured.
  • the endoscope 1 is a flexible endoscope used for general endoscopic surgery, and includes a shaft 2 inserted into a digestive tract of a living body, an operation unit 3 for operating the shaft 2, and a shaft 2. A portion connected to a light source body that supplies light to the tip is provided.
  • the diameter, length, material, and the like of the tube are not particularly limited.
  • the diameter of the tube 2 is about 10 mm in a general endoscope, but may be about 5 to 15 mm.
  • the length of the tube 2 is about 1200 mm in a general endoscope, but may be about 1200 to 3000 mm.
  • the endoscope 1 when performing surgery on an organ in the abdominal cavity, the endoscope 1 preferably has a narrow-band light observation (NBI) function or a water jet function.
  • NBI narrow-band light observation
  • symbol 5 has shown the outer cylinder in which the shaft 2 of the endoscope 1 is penetrated.
  • the outer cylinder 5 guides the movement of the shaft 2 when the shaft 2 of the endoscope 1 is inserted into and removed from the living body, and is formed by a hollow cylindrical member that is long in the axial direction.
  • the length of the outer cylinder 5 is shorter than the length of the shaft 2. That is, if the shaft 2 of the endoscope 1 is inserted into the hollow space from one end (base end) of the outer cylinder 5, the tip of the shaft 2 can be projected from the other end (tip).
  • the shaft 2 is formed so that the tip of the shaft 2 can be projected and retracted from the tip of the outer cylinder 5 by moving the shaft 2 in the axial direction in a state of being disposed in a hollow space.
  • the outer cylinder 5 may have an inner diameter, a thickness, a length, a material, etc., as long as it is generally used when the endoscope 2 is inserted into the digestive tract of a living body to perform inspection or surgery. Is not particularly limited.
  • the inner diameter of the outer cylinder 5 is generally about 20 mm, but any shaft can be used as long as the shaft 2 can be inserted and the shaft 2 can be smoothly moved along the axial direction.
  • the inner diameter of the outer cylinder 5 may be about 10 to 30 mm.
  • the thickness of the outer cylinder 5 is generally several mm if the inner diameter of the outer cylinder 5 is about 20 mm, but is thick enough to insert the outer diameter of the outer cylinder 5 into the digestive tract.
  • the thickness of the outer cylinder 5 will not be specifically limited. Further, the length of the outer cylinder 5 only needs to be shorter than the length of the shaft 2. That is, when the shaft 2 is inserted from one end of the outer cylinder 5, the tip of the shaft 2 can be projected from one end of the outer cylinder 5 by a predetermined length (for example, about 10 to 500 mm). Well, not particularly limited.
  • the outer diameter of the outer tube 5 is 15 to 25 mm. It is preferable that the length is about 500 to 1000 mm and that the tube 2 of the endoscope 1 is formed of a material that can be smoothly inserted, removed, and rotated.
  • the area securing instrument 10 is a cylindrical member having a hollow passage that passes through the axial direction thereof, and is disposed between the outer cylinder 5 and the shaft 2 of the endoscope 1. Specifically, the area securing instrument 10 is inserted into the outer cylinder 5, and the shaft 2 of the endoscope 1 is inserted into the hollow passage.
  • the area securing instrument 10 includes a hollow cylindrical connecting pipe 15 and a hollow main body 11 attached to the tip (left end in FIG. 1) of the connecting pipe 15.
  • the region securing instrument 10 is inserted into the outer cylinder 5 such that the main body 11 is located on the distal end side of the outer cylinder 5 and the distal end of the main body 11 does not protrude from the distal end of the outer cylinder 5.
  • the area securing instrument 10 is formed such that its axial length (that is, the length from the proximal end of the connecting tube 15 to the distal end of the main body 11) is longer than that of the outer cylinder 5.
  • the main body portion 11 of the area securing instrument 10 is contracted in a state where it is accommodated in the outer cylinder 5, but when the tip portion protrudes outside from the tip of the outer tube 5, the tip portion expands. It has such a structure. Specifically, when the tip of the main body 11 protrudes from the tip of the outer cylinder 5 to the outside, the tip of the main body 11 can be expanded (expanded), and the opening area of the tip can be increased. It has a structure that can be larger than the cross-sectional area.
  • the area securing instrument 10 functions as follows, and therefore the field of view of the endoscope 1 is secured. It is possible to secure a surgical field. In the following, a case where a field of view or the like is secured by the region securing instrument 10 in the collapsed stomach will be described as a representative.
  • the outer cylinder 5 is inserted from the patient's mouth, and the distal end of the outer cylinder 5 is placed in the collapsed stomach. Then, the endoscope 1 and the area securing instrument 10 are inserted through the outer cylinder 5 (FIG. 4A).
  • the area securing instrument 10 is moved along the axial direction of the outer cylinder 5 so that the main body portion 11 protrudes from the distal end of the outer cylinder 5 and the distal end is enlarged (expanded).
  • the opening area of the distal end becomes larger than the cross-sectional area of the outer cylinder 5, so that the stomach wall ST is pushed outward by the outer edge of the distal end of the main body 11.
  • the stomach can be expanded (deployed) (FIG. 4B). That is, by pressing the stomach wall ST outwardly by the distal outer edge of the main body part 11, tension is applied to the gastric wall ST surrounded by the distal outer edge of the main body part 11 so that the stomach wall ST is stretched. is there.
  • the opening area at the distal end of the main body portion 11 becomes larger than the cross-sectional area of the outer cylinder 5, so that the gastric wall developed through the space in the main body portion 11. Confirmation of the inner surface of ST becomes easy. And since the space in the main-body part 11 becomes large compared with the diameter of an endoscope, etc., it becomes easy to perform treatments, such as excision of the stomach wall ST.
  • stomach wall ST is supported by the tip of body part 11, part of stomach wall ST is excised and a penetration hole is formed in stomach wall ST. Even if formed, the stomach will not collapse. In other words, the portion of the stomach wall ST disposed in the opening at the tip of the main body 11 is maintained in a deployed state (a stretched state, so-called counter traction, triangulation). Then, since the field of view of the endoscope can be secured at all times in the portion surrounded by the opening at the distal end of the main body 11, the operation of the endoscope 1 can be continued in a stable state.
  • the body part 11 of the region securing tool 10 is moved along the axial direction of the outer cylinder 5, the body part 11 is moved to the outer cylinder. 5 can be accommodated. Then, when changing the place where the examination or treatment is performed, if the outer cylinder 5 is moved in a state where the main body 11 is accommodated in the outer cylinder 5, the main body 11 can also be moved together. It is easy to change the place where the operation is performed and to arrange the main body 11 at the place.
  • the place where the operation or the like is performed may be changed while the main body 11 is projected from the outer cylinder 5. That is, the place where the operation or the like is performed may be changed by moving the distal edge 11a along the stomach wall ST while the distal edge 11a of the main body 11 is in contact with the stomach wall ST (see FIG. 4C). ).
  • the stomach collapses when the main body 11 is accommodated in the outer cylinder 5 the portion of the stomach wall ST surrounded by the opening at the tip of the main body 11 is expanded. Can do.
  • the location can be changed while confirming the stomach wall ST, it is preferable in that the incision of the stomach wall ST can be performed safely. Further, since the state of the stomach wall ST can be confirmed even while moving, it is also preferable in that the possibility of missing a lesion or the like can be reduced.
  • the distal edge 11a of the main body 11 When the distal edge 11a of the main body 11 is moved while being in contact with the stomach wall ST, the distal edge 11a in contact with the stomach wall ST is coated with a hydrophilic substance, or only the distal edge 11a is hydrophilic. It is preferable that the main body 11 is entirely formed of a hydrophilic substance. Then, since the hydrophilic substance has a small resistance to the stomach wall ST, when the distal end edge 11a of the main body 11 is in contact with the stomach wall ST and is slid and moved on the inner surface of the stomach wall ST, the resistance is reduced. Therefore, the main body 11 can be moved smoothly.
  • the main body 11 is a member formed in a cylindrical shape, and has one end (the right end in FIGS. 2 and 3, hereinafter referred to as a base end) and the other end (in FIGS. 2 and 3). A space communicating with the left end (hereinafter referred to as the tip) is formed.
  • the main body 11 is formed in such a size that the hollow space can be inserted through the shaft 2 of the endoscope 1. Specifically, the cross-sectional area of the hollow space in the main body 11 is formed to be larger than the cross-sectional area of the shaft 2 of the endoscope 1.
  • the main body 11 is formed such that the opening area of the hollow space is gradually increased from the base end toward the tip, and the opening area of the tip is larger than the cross-sectional area of the outer cylinder 5. . That is, the main body 11 is formed so that the appearance thereof is a trumpet shape. For example, as shown in FIG.
  • the length L of the main body 11 is about 300 to 1000 mm
  • the inner diameter of the opening at the proximal end is about 15 to 25 mm
  • the inner diameter D of the opening is formed to be about 15 to 70 mm, a visual field suitable for cholecystectomy, gastrojejunostomy, fallopian tube ligation, etc., and a surgical field for surgery can be secured.
  • the main body 11 is formed so as to be able to expand and contract in a direction intersecting with the central axis CL of the hollow space.
  • the main body 11 is formed of a shape memory material such as a material or an elastic material such as a metal, and in a state where no force is applied to the outer surface, the main body 11 has a trumpet shape as described above.
  • the cross-sectional area of the distal end and the proximal end is adjusted so as to be a substantially cylindrical shape.
  • the main body 11 maintains the trumpet shape (original shape) even when a force below a certain level is applied in the direction toward the center axis CL from the trumpet shape state, and moves toward the center axis CL.
  • the hollow space is formed to shrink so that the cross-sectional area becomes small.
  • the main body part 11 when the hollow space of the main body part 11 is circular, when a force of a certain level or more is applied along the direction from the outer surface of the main body part 11 toward the central axis, the main body part 11 has a cross-sectional shape of the hollow space. Is adjusted to shrink while maintaining a substantially circular state (in other words, a shape similar to the opening cross-sectional shape of the tip in the original shape).
  • the main body 11 When the main body 11 is inserted into the outer cylinder 5 from the opening (for example, the front end), the main body 11 is inserted into the main body 11 from the outer surface thereof in the direction intersecting the central axis CL of the hollow space. A certain force or more can be applied along the direction toward CL. Then, since the main body part 11 contracts, the main body part 11 can be inserted into the outer cylinder 5. On the other hand, when the front end of the main body 11 is protruded from the outer cylinder 5, the portion protruding from the main body 11 is released from the above force, so that the entire main body 11 is protruded from the outer cylinder 5. The main body 11 can be automatically brought into the original shape.
  • the stomach wall ST can be pushed outward by a front-end
  • the opening area at the front end of the main body 11 when the entire main body 11 is protruded from the outer cylinder 5 is almost automatically determined by the protruding amount of the main body 11 from the front end of the outer cylinder 5. To be determined.
  • the main body 11 is provided with a mechanism capable of adjusting the opening area of the distal end regardless of the amount of protrusion from the distal end of the outer cylinder 5, a field of view and a surgical field suitable for a site to be observed or treated can be formed. ,preferable.
  • a wire is arranged in a ring shape along the distal end edge 11a of the main body 11, and one end thereof is fixed to the distal end edge 11a, and the other end is a hand of the area securing instrument 10, that is, an internal view. It is arranged near the operation unit 3 of the mirror 1.
  • wheel formed with a wire is provided so that a ring
  • the main-body part 11 should just be made into the shape suitable according to the place to use, a treatment, etc., and it cannot be overemphasized that it is not limited to said size and shape.
  • the appearance is a trumpet shape
  • the length L of the main body 11 is the same, a wide field of view can be secured by increasing the angle ⁇ formed between the central axis CL of the hollow space and the inner surface. If it is made smaller, the distance from the stomach wall ST or the like can be made larger, so the length L and the angle ⁇ of the main body 11 may be set appropriately according to the place and treatment used.
  • the appearance may not necessarily be a trumpet shape, and may be a columnar shape, an elliptical shape in a side view, a radial shape, or the like.
  • a main body 11 having a cylindrical shape having an inner diameter larger than that of the outer cylinder 5 when protruding from the outer cylinder 5 can be employed.
  • the large intestine and the like can be formed in a cylindrical shape, and the inner wall and the like can be easily inspected.
  • the distance between the tip of the tube 2 and the inner wall of the digestive tract can be taken by the length of the main body 11 in the axial direction.
  • the part disposed in the through-hole can be inspected by the endoscope 1.
  • the main body 11 has a shape that has an elliptical shape in a side view when projected from the outer cylinder 5, in other words, a portion 11d that swells between the distal end and the proximal end. If it makes it, the advantage that it becomes easy to perform the operation
  • the shaft 1B of one endoscope 1B is used for observing blood vessels and the like on the outer surface of the stomach wall ST through the stomach wall ST, and the shaft of the other endoscope 1A. Surgery may be performed with 1A.
  • the stomach wall ST in a state of being developed by the main body part 11 can be operated, and the distal end portion of the main body part 11 penetrates the stomach wall ST through the shaft 1B. It is preferable because it does not get in the way.
  • a dividing plate 10p that divides the inside of the communicating pipe 15 and the inside of the main body 11 into two spaces along the axial direction of the main body 11 and the communicating pipe 15 may be provided.
  • the shaft 2A and the shaft 2B are passed through the spaces of the communication pipe 15 during the operation with the double scope, because problems such as the shafts 2A and 2B entangled do not occur.
  • the one where the opening area of the main-body part 11 is large is preferable since the place which penetrates the stomach wall ST can be ensured, taking a large surgical field.
  • the cross-sectional shape of the hollow space in the main body 11 is not limited to a circle (see FIG. 2), and may be an elliptical shape or a polygonal shape such as a quadrangle.
  • a shape such as a circle or an ellipse that does not have an angular portion on the outer periphery because the force applied to the organ or the like can be reduced when it comes into contact with the organ or the like.
  • the main body 11 only needs to be formed so as to be able to expand and contract in the direction intersecting the central axis CL of the hollow space, and the material has elasticity such as the shape memory material and metal as described above.
  • a sheet-shaped member may be stretched on a framework formed of an elastic material such as rubber or metal to form a trumpet.
  • the main body 11 can be accommodated in the outer cylinder 5 by constricting the tip, and the main body 11 can be formed in a trumpet shape by protruding from the outer cylinder 5.
  • a stretchable material such as rubber as a sheet-like member stretched around the framework.
  • the sheet-like member contracts even if it is housed in the outer cylinder 5 when the tip is constricted, so that the sheet-like member does not hang down between the frames. This is preferable because it does not obstruct the movement of the shaft 2 of the endoscope 1 or obstruct the visual field.
  • the sheet-like member is not a stretchable material, it can be prevented that the sheet-like member hangs down between the frames if the structure is foldable in a bellows shape. You can get an effect.
  • a hole that communicates between the inside and the outside may be provided in the main body 11. Then, even if liquids such as gastric juice and blood enter the space in the main body 11, these liquids can be discharged to the outside through the holes. Then, it is possible to prevent the liquid from accumulating in the space in the main body 11 and obstructing the observation by the endoscope 1.
  • the main body portion 30 includes a cylindrical support portion 31 having a hollow space, and a region holding portion 32 having a plurality of region holding pieces 33 having base ends connected to the support portion 31, It has.
  • the support portion 31 is a cylindrical member having a hollow space 31h penetrating along the axial direction.
  • the support portion 31 is formed so that the cross-sectional area of the hollow space 31 h is larger than the cross-sectional area of the shaft 2 of the endoscope 1. That is, the support part 31 is formed so that the shaft 2 can be inserted through the hollow space 31h.
  • the base end of a plurality of area holding pieces 33 of the area holding part 32 is connected to the support part 31.
  • the plurality of region holding pieces 33 are formed of an elastic material, and are provided at the tip of the support portion 31 along the circumferential direction as shown in FIG.
  • the plurality of region holding pieces 33 are provided so as to be rotationally symmetric with each other (in other words, every predetermined angle).
  • Each region holding piece 33 is provided so that its distal end can swing in the radial direction of the support portion 31 with its base end as a fulcrum. In other words, each region holding piece 33 is provided such that the tip thereof can approach and separate from the direction of the central axis 31 c of the support portion 31.
  • region holding piece 33 is normally formed so that the front-end
  • the cross-sectional area is formed to be larger than the cross-sectional area of the hollow space 31 h of the support portion 31 and the cross-sectional area of the outer cylinder 5.
  • the area of a circle e formed by connecting the tips of the plurality of region holding pieces 33 is formed to be larger than the cross-sectional area of the space 31 h and the cross-sectional area of the outer cylinder 5.
  • the region The distal end portion of the holding piece 33 can be deformed so as to approach the central axis of the support portion 31 (in other words, it can be swung inward).
  • the region holding piece 33 is deformed so as to be separated from the central axis of the support portion 31. That is, the region holding piece 33 is deformed so as to return to the original state. That is, the tip of the area holding piece 33 swings outward.
  • the stomach wall ST can be pushed outward by the distal end portion of the main body portion 30, that is, the distal end portions of the plurality of region holding pieces 33, and the stomach is expanded (deployed). Can do.
  • the front end of the region holding piece 33 can be used as the central axis of the support portion 31 simply by causing the main body 30 to protrude from the front end of the outer cylinder 5 or by pushing or pulling in from the front end of the outer cylinder 5. It can approach and separate. This eliminates the need for a special mechanism for moving the distal end portion of the region holding piece 33 toward and away from the central axis of the support portion 31, so that the structure of the instrument can be simplified.
  • the shape and material of the region holding piece 33 are not particularly limited.
  • a leaf spring or the like can be used, and a wire formed of an elastic material as shown in FIG.
  • the region holding piece 33 may be formed.
  • the region holding piece 33 may be structured such that the plurality of region holding pieces 33 can swing independently, or all the region holding pieces 33 may swing in the same manner.
  • a sheet-like member may be stretched between the region holding pieces 33 so as to cover the region holding pieces 33.
  • the connecting pipe 15 is a cylindrical member extending along the axial direction, and a hollow space penetrating between one end and the other end is formed.
  • the hollow space is formed in such a size that the shaft 2 of the endoscope 1 can be smoothly inserted therein, and is communicated with the hollow space of the main body 11 so as to be substantially coaxial.
  • the connecting tube 15 has a length in the axial direction that is a combined length from the base end of the connecting tube 15 to the tip of the main body 11 in the state where the main body 11 is provided at the front end. Is formed to be longer than the outer cylinder 5. Then, if the base end of the connecting pipe 15 is operated, the tip of the main body 11 can be projected and retracted from the tip of the outer cylinder 5, so that a special mechanism for projecting and retracting the main body 11 from the distal end of the outer cylinder 5 is provided. Since it becomes unnecessary, the structure of the area securing instrument 10 can be made simple.
  • the material of the connecting tube 15 is not particularly limited, but when the outer tube 5 or the shaft 2 of the endoscope 1 is bent, the connecting tube 15 is flexible enough to follow its movement, Those having such a strength that the shape can be maintained even when a certain amount of force is applied from the radial direction are preferable.
  • polyethylene preparations, plastic preparations, urethane preparations, and the like, which are materials generally used for the outer cylinder 5, can be used, but are not particularly limited as long as the materials satisfy the above functions.
  • the area securing instrument 10 includes a mechanism that allows the main body portion 11 to appear and disappear from the outside of the outer cylinder 5 and that can maintain the position of the main body portion 11 in the outer cylinder 5. If so, the connecting pipe 15 may not be provided. However, if the area securing instrument 10 includes the connecting pipe 15 as described above, the length of the main body 11 protruding from the outer cylinder 5 or the outer cylinder 5 can be adjusted by operating the proximal end of the connecting pipe 15. Since the position of the main body 11 in the stomach, stomach, and abdominal cavity can be adjusted, there is an advantage that these adjustments are easy.
  • the position of the main body 11 in the outer cylinder 5, the stomach, and the abdominal cavity can be fixed simply by fixing the movement of the proximal end of the connecting tube 15 to the shaft 2 itself of the endoscope 1.
  • the position of the portion 11 can be easily fixed.
  • the main body has the structure of FIG. 1 (that is, the case of the main body 11)
  • the main body having the structure shown in FIG. 6 or the structure shown in FIG.
  • an extension part can be provided by the same method.
  • a case where the main body portion and the extension portion have a substantially equivalent structure in other words, a case where both are substantially similar to each other will be described, but the main body portion and the extension portion do not necessarily have a substantially equivalent structure.
  • the main body part 11 and the main body part 30 may be a combination of extensions having a substantially equivalent structure, or vice versa.
  • the main body portion and the extension portion are substantially similar, the arrangement and combination of both are facilitated, and interference between the two can be prevented from occurring when enlarged and reduced.
  • the extension portion 21 has a structure substantially equivalent to that of the main body portion 11. That is, the extension portion 21 is formed in a cylindrical shape, and has one end (right end portion in FIGS. 9 and 10, hereinafter referred to as a base end) and the other end (left end portion in FIGS. 9 and 10, hereinafter, A space communicating with the tip) is formed.
  • the hollow space of the extension portion 21 is formed in a size that allows the shaft 2 of the endoscope 1 to be inserted, like the main body portion 11.
  • the extension portion 21 is made of a shape memory material such as a material or an elastic material such as metal, and has an outer appearance with a trumpet shape. It is formed to be larger than the area.
  • the extension portion 21 also has a trumpet shape as described above when no force is applied to the outer surface thereof, but when a force is applied to the outer surface, the cross-sectional areas of the distal end and the proximal end are approximately the same. (See FIG. 11).
  • the extension 21 is substantially the same shape and substantially similar to the main body 11, but is formed in a size that can be accommodated in the space inside the main body 11. Specifically, when the force is applied to the outer surface of the extension portion 21 and the cross-sectional area of the distal end and the proximal end becomes a substantially cylindrical shape, the outer diameter of the extension portion 21 is when the main body portion 11 becomes a cylindrical shape. Are formed so as to be smaller than the inner diameter of the space formed therein.
  • a hollow cylindrical extension connecting pipe 25 is connected to the base end of the extension portion 21.
  • the extended connecting pipe 25 has substantially the same shape as the connecting pipe 15 that operates the main body 11, but can be accommodated in the connecting pipe 15 and can move along the axial direction of the connecting pipe 15. Is formed. That is, the extension connecting pipe 25 is formed so that its inner diameter is larger than the outer diameter of the shaft 2 of the endoscope 1 but its outer diameter is smaller than the inner diameter of the connecting pipe 15. On the other hand, the extension connecting pipe 25 is formed so that the length from the base end to the tip of the extension portion 21 is longer than the connecting pipe 15. For this reason, when the extension connecting pipe 25 is operated along the axial direction, the tip of the extension portion 21 accommodated in the main body portion 11 can appear and disappear from the tip end of the main body portion 11.
  • the method for causing the tip of the extension 21 to protrude from the tip of the main body 11 is not limited to the structure as described above.
  • the extension connecting pipe 25 and the connecting pipe 15 can be provided by making the length of the extension 21 itself in the axial direction longer than that of the main body 11. Even when the same is moved by the same amount, the tip of the extension portion 21 can appear and disappear from the tip of the main body portion 11.
  • extension part 21 has the structure as described above, the extension part 21 and the extension connection pipe 25 can be provided in the main body part 11 and the connection pipe 15. 11, the tip of the shaft 2 of the endoscope 1 can be arranged (see FIGS. 9 and 10).
  • the extension portion 21 When the extension portion 21 is provided, even if the stomach wall ST or the organ lifted by the main body portion 11 hangs down on the front surface of the main body portion 11, the extension portion 21 protrudes from the tip of the main body portion 11, thereby The stomach wall ST and the like that hangs down on the front surface can be lifted by the extension 21. Then, the axial direction of the outer cylinder 5, that is, the visual field or surgical field having a large depth can be secured in depth compared to the case where the visual field of the endoscope 1 or the surgical surgical field is secured only by the main body 11. (FIG. 11 (A)).
  • the visual field region is ensured while ensuring a visual field region of a certain level or more.
  • the outer cylinder 5 is moved so that the tip thereof reaches the position of the tip of the main body 11, and the main body 11 is accommodated in the outer cylinder 5.
  • the area on the front surface of the endoscope is secured by the extension 21 (FIG. 11B).
  • the outer cylinder 5 is moved so that the tip thereof reaches the position of the tip of the extension portion 21, and the extension portion 21 is accommodated in the outer cylinder 5 (FIG. 11C). If it will be in this state, the area
  • the extension portion 21 is not particularly limited in the cross-sectional area (in other words, the diameter D2) of the tip portion in an enlarged state.
  • the extension portion 21 has a cross-sectional area (in other words, a diameter D2) of the distal end portion in an enlarged state. In other words, it is preferably formed so as to be smaller than the diameter D1).
  • the extension portion 21 having a small cross-sectional area is located at the tip, it is easy to enter the organ or the deflated stomach. And if it is an area
  • Multiple extensions 21 In the above example, the case where only one extension portion 21 is provided has been described. However, a plurality of extensions 21 may be provided. Specifically, a plurality of extension portions 21 having different end areas in the contracted state, in other words, different in outer diameter and inner diameter when contracted into a cylindrical shape. Provide. Then, another extension portion 21 having an inner diameter smaller than that of the one extension portion 21 is disposed in the one extension portion 21. At this time, the other extension portion 21 can move in the axial direction of the one extension portion 21 in a state where the other extension portion 21 is disposed in the one extension portion 21. Then, if the other extension 21 is moved in the axial direction, the tip of the other extension 21 can be protruded from the tip of the one extension 21.
  • the plurality of extensions 21 can be used in the depth direction of the field of view of the endoscope. It becomes easy to secure a wider area. Further, if the main body 11 and the plurality of extensions 21 are moved while being expanded and contracted (see FIG. 11), the shaft 2 of the endoscope 1 is moved while searching for the affected part in a deflated stomach or abdominal cavity. Sometimes, the shaft 2 becomes easy to move.
  • all the extensions 21 do not necessarily have a substantially equivalent structure, and extensions having different structures may be combined. However, when all the extension portions 21 have substantially the same structure and are substantially similar, the arrangement of the plurality of extension portions 21 is facilitated, and interference between the extension portions 21 occurs when enlarged or reduced. It can be made difficult to occur.
  • each extension 21 is not particularly limited. For example, what is necessary is just to set it as the structure which each provides the extended connection pipe
  • the inner diameter of the extension connecting pipe 25 connected to one extension 21 is larger than the outer diameter of the extension connecting pipe 25 connected to the other extension 21 accommodated in the one extension 21. As long as it is larger.
  • the extension 21 having the smallest inner diameter that is, the extension 21 having the smallest cross-sectional area of the tip in the contracted state
  • the extension connecting pipe 25 connected to the extension 21 are provided. Is formed to be larger than the outer diameter of the shaft 2 of the endoscope 1 (in other words, larger than the cross-sectional area of the shaft 2 of the endoscope 1).
  • the method of making the tip of the other extension part 21 accommodated in the one extension part 21 protrude from the tip of the one extension part 12 is not particularly limited.
  • the extension connection pipe 25 of the other extension part 21 may be made longer than the extension connection pipe 25 of the one extension part 21, or the length of the extension connection pipe 25 may be the same and the axis of the other extension part 21 may be the same.
  • the length in the direction may be longer than the length in the axial direction of one extension portion 21.
  • the region securing device is a transluminal intraluminal operation for performing a procedure for forming a through-hole in the digestive tract or an operation in the abdominal cavity with an endoscope inserted in a digestive tract cavity such as the mouth, anus, or vagina. Suitable for instruments that secure the field of view and surgical field of endoscopic surgery.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Biomedical Technology (AREA)
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  • Optics & Photonics (AREA)
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  • Radiology & Medical Imaging (AREA)
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  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Endoscopes (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne un outil de protection de région avec lequel il est possible de protéger un champ de visée d'une partie sur laquelle une opération est prévue et un champ d'opération dans une NOTES, et un endoscope qui comprend l'outil de protection de région. Un outil de protection de région (10) qui est utilisé en chirurgie endoscopique transluminale d'orifice naturel (NOTES) comprend une partie de corps principal cylindrique (11) ayant un espace creux. L'espace creux de la partie de corps principal (11) est formé de sorte que l'aire de section transversale de celui-ci soit plus grande que l'aire de section transversale d'une tige (2) d'un endoscope (1), et il est possible que la partie de corps principal (11) se dilate et se contracte dans la direction qui coupe l'axe central (CL) de l'espace creux. En amenant la partie de corps principal (11) à faire saillie et s'expanser depuis la partie d'extrémité avant d'un cylindre externe (5), il est possible de protéger un champ de visée d'un endoscope par la partie de corps principal (11) et un champ d'opération pour une opération par l'endoscope (1). En formant la partie de corps principal (11) à une taille qui peut être logée dans le cylindre externe (5) lorsqu'elle est contractée, il est possible de déplacer la partie de corps principal (11) dans l'état dans lequel elle est logée dans le cylindre externe (5) à un site où l'opération, etc., est conduite, de manière à simplifier le positionnement de la partie de corps principal (11) au site où l'opération, etc., est conduite.
PCT/JP2013/001455 2012-03-08 2013-03-07 Outil de protection de région et endoscope comprenant l'outil de protection de région WO2013132861A1 (fr)

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JP2012051305A JP5975257B2 (ja) 2012-03-08 2012-03-08 領域確保用器具および領域確保用器具を備えた内視鏡
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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9808142B2 (en) 2010-05-25 2017-11-07 Arc Medical Design Limited Covering for a medical scoping device
US11172807B2 (en) 2016-05-23 2021-11-16 Olympus Corporation Endoscope device and endoscope system with deforming insertion portion wire

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP5918577B2 (ja) * 2012-03-08 2016-05-18 株式会社リバーセイコー 体腔内観察視野確保装置
JP7085401B2 (ja) * 2018-04-27 2022-06-16 川崎重工業株式会社 外科手術システム

Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPS57136430A (en) * 1981-02-18 1982-08-23 Olympus Optical Co Endoscope
JPS5994315U (ja) * 1982-12-13 1984-06-27 住友電気工業株式会社 イメ−ジフアイバ装置
JPH11299725A (ja) * 1998-04-21 1999-11-02 Olympus Optical Co Ltd 内視鏡用フード
JP2009531081A (ja) * 2006-03-17 2009-09-03 ボエッジ メディカル， インコーポレイテッド 組織可視化および操作システム
JP2009539575A (ja) * 2006-06-14 2009-11-19 ボエッジ メディカル， インコーポレイテッド 経中隔アクセスのための可視化装置および方法
JP2009273570A (ja) * 2008-05-13 2009-11-26 Hoya Corp 内視鏡用フード
JP2010502313A (ja) * 2006-09-01 2010-01-28 ボエッジ メディカル， インコーポレイテッド 心房細動の治療のための方法および装置
JP2010524651A (ja) * 2007-04-27 2010-07-22 ボエッジ メディカル， インコーポレイテッド 複雑な形状の操縦可能な組織可視化および操作カテーテル
JP2011152449A (ja) * 2005-02-02 2011-08-11 Voyage Medical Inc 組織の可視化および操作システム
JP2012040108A (ja) * 2010-08-17 2012-03-01 Morita Mfg Co Ltd 内視鏡先端カバーおよび内視鏡

Patent Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPS57136430A (en) * 1981-02-18 1982-08-23 Olympus Optical Co Endoscope
JPS5994315U (ja) * 1982-12-13 1984-06-27 住友電気工業株式会社 イメ−ジフアイバ装置
JPH11299725A (ja) * 1998-04-21 1999-11-02 Olympus Optical Co Ltd 内視鏡用フード
JP2011152449A (ja) * 2005-02-02 2011-08-11 Voyage Medical Inc 組織の可視化および操作システム
JP2009531081A (ja) * 2006-03-17 2009-09-03 ボエッジ メディカル， インコーポレイテッド 組織可視化および操作システム
JP2009539575A (ja) * 2006-06-14 2009-11-19 ボエッジ メディカル， インコーポレイテッド 経中隔アクセスのための可視化装置および方法
JP2010502313A (ja) * 2006-09-01 2010-01-28 ボエッジ メディカル， インコーポレイテッド 心房細動の治療のための方法および装置
JP2010524651A (ja) * 2007-04-27 2010-07-22 ボエッジ メディカル， インコーポレイテッド 複雑な形状の操縦可能な組織可視化および操作カテーテル
JP2009273570A (ja) * 2008-05-13 2009-11-26 Hoya Corp 内視鏡用フード
JP2012040108A (ja) * 2010-08-17 2012-03-01 Morita Mfg Co Ltd 内視鏡先端カバーおよび内視鏡

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9808142B2 (en) 2010-05-25 2017-11-07 Arc Medical Design Limited Covering for a medical scoping device
US10722103B2 (en) 2010-05-25 2020-07-28 Arc Medical Design Limited Covering for a medical scoping device
US11382494B2 (en) 2010-05-25 2022-07-12 Keymed (Medical & Industrial Equipment) Limited Covering for a medical scoping device
US11172807B2 (en) 2016-05-23 2021-11-16 Olympus Corporation Endoscope device and endoscope system with deforming insertion portion wire

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