WO2015060034A1 - 弾性チューブ、制御装置および医療機器 - Google Patents
弾性チューブ、制御装置および医療機器 Download PDFInfo
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- WO2015060034A1 WO2015060034A1 PCT/JP2014/073943 JP2014073943W WO2015060034A1 WO 2015060034 A1 WO2015060034 A1 WO 2015060034A1 JP 2014073943 W JP2014073943 W JP 2014073943W WO 2015060034 A1 WO2015060034 A1 WO 2015060034A1
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- elastic tube
- elastic
- tube
- main body
- stretchable
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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
- A61B1/313—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 introducing through surgical openings, e.g. laparoscopes
- A61B1/3132—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 introducing through surgical openings, e.g. laparoscopes for laparoscopy
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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
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B1/00064—Constructional details of the endoscope body
- A61B1/00103—Constructional details of the endoscope body designed for single use
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- 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
- A61B1/00142—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 with means for preventing contamination, e.g. by using a sanitary sheath
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- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
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- A—HUMAN NECESSITIES
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- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
- A61M25/0133—Tip steering devices
- A61M25/0155—Tip steering devices with hydraulic or pneumatic means, e.g. balloons or inflatable compartments
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- A61B1/0011—Manufacturing of endoscope parts
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- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
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- A61B2017/22051—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
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- A61B2018/2238—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor with means for selectively laterally deflecting the tip of the fibre
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- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/37—Surgical systems with images on a monitor during operation
Definitions
- the present invention relates to an elastic tube, a control device, and a medical device.
- an endoscope apparatus that performs imaging of an affected area when operating a patient, for example, a medical device as an endoscope apparatus suitable for use in single-hole laparoscopic cholecystectomy About.
- the present invention relates to a medical device including a catheter, a laser knife, or an electric knife as a medical instrument.
- FIG. 12 is a front view showing a state of conventional surgery.
- the surgeon (camera assistant) 104 operates the endoscope camera 103 to project the state of the patient 101 inside the camera monitor 6.
- a surgeon (operator) 105 other than the camera assistant 104 operates the two forceps 102, one for each of the right hand and the left hand, while looking at the camera monitor 6.
- the endoscopic camera 103 wraps around the forceps 102 and reflects the affected area of the patient 101.
- Reference numeral 8 denotes an operating table on which a patient 101 is placed.
- Single-hole laparoscopic cholecystectomy has the following advantages because the wound is only in the navel. (1) It is cosmetically superior because scratches are not noticeable. (2) Less pain after surgery. (3) Because recovery is fast, the patient can be discharged in a shorter hospitalization period (2 to 3 days) than the conventional surgical method. Therefore, medical expenses can be suppressed. (4) Even a patient (elderly) whose physical strength has decreased because the burden on the body is small, the operation can be safely performed.
- the distal end portion of the endoscope apparatus needs to have a bendable structure in order to image the treatment site in the abdominal cavity.
- This curved structure is generally composed of a plurality of joints and wires operated by pulling the joints.
- a structure in which a fluid is supplied to the inside, the membrane is expanded by the fluid pressure, and a bending motion is caused by the tensile stress generated in the membrane Patent Document 1. More specifically, it is a balloon actuator in which two film bodies having different tensile stresses caused by elongation are combined, and by forming one film body in a concave shape, a portion between the two film bodies is partially formed. A configuration for forming a plurality of spaces is disclosed.
- Patent Document 2 discloses a configuration in which a bending operation is performed by adjusting the pressure inside a cylindrical body that includes a cylindrical elastic body and a reinforcing member that is less elastically deformed than the cylindrical elastic body.
- Patent Document 3 discloses a configuration including an air bag, a braid surrounding the air bag, and a back column bent in an arc shape disposed between the air bag and the braid.
- Patent Document 1 is a complex configuration in which two film bodies are combined and one film body is formed in a concave shape, it cannot be easily manufactured.
- Patent Document 2 since the reinforcing member has a size that completely covers the bottom surface of the cylindrical elastic body, the corners on the side surfaces of the reinforcing member cause invasion of the human body when performing a bending operation. There is a fear.
- the structure disclosed by patent document 3 consists of a several different raw material, it cannot manufacture easily.
- the present invention adopts a novel structure for bending operation at the distal end portion of a medical device such as an endoscope apparatus, thereby realizing a safe device with a simple structure, and the bending operation can be automatically operated by a control device.
- a medical device such as an endoscope apparatus
- the problems in the conventional single-hole laparoscopic cholecystectomy described above are solved.
- An elastic tube according to the present invention includes an elastic tube main body having an elongated hollow cylindrical shape, a fixing portion provided at one sealed end of the elastic tube main body to which a medical instrument can be attached, and a length of the elastic tube main body.
- a non-stretchable body having a flexible portion fixed in the axial direction, and by controlling the pressure of the gas injected into the elastic tube body, the opposite side of the non-stretchable body It is used for a medical device characterized by expanding or contracting.
- gas for example, air
- the elastic tube is bent using the pressure of the gas. Even if it comes into contact with the organ), the elastic tube is deformed and absorbs the shock caused by the contact, so that it is safe without damaging the medical treatment site.
- the structure of the elastic tube is simple, it can be manufactured at a low cost, and can be easily made disposable, thereby maintaining cleanliness.
- the present invention while adopting a simple structure that can be manufactured easily and inexpensively, has much superior convenience in the medical field in terms of being disposable and not invading the human body. It is expected to spread widely in the medical field.
- FIG. 1 It is a figure which shows the structure of the medical device (endoscope apparatus) provided with the elastic tube which concerns on this Embodiment. It is a perspective view which shows the endoscope part (medical equipment part) of the endoscope apparatus (medical equipment) in FIG. It is the sectional view on the AA line of the endoscope part in (a) of Drawing 2.
- (A) is a cross-sectional view taken along the line BB of the elastic tube in FIG. 3
- (b) to (f) are diagrams showing modifications of the elastic tube
- (g) to (i) are diagrams of the elastic tube.
- (A)-(d) is a figure which shows the other modification of an elastic tube.
- (A) is a figure which shows an example of a bellows structure
- (b) is a figure which shows an example of a mesh structure. It is sectional drawing which shows a syringe and a piston part.
- (A) is a diagram showing the relationship between the pressure P and the bending angle ⁇ in the elastic tube shown in (a) to (c) of FIG. 4, and (b) is a diagram of (d) to (f) of FIG. It is a figure which shows the relationship between the pressure P and bending angle (theta) in the elastic tube shown in FIG.
- (A) And (c) is a graph which shows the relationship between the tube internal pressure of an elastic tube, and the cross-sectional area of a hollow part, (b) and (d) show the relationship between tube internal pressure and the curve angle of a tube. It is a graph. It is a front view which shows the condition of medical treatment (surgery).
- (A) And (b) is a perspective view which shows the outline of a multi-joint bending part. It is a front view which shows the condition of the conventional medical treatment (surgery).
- FIG. 1 is a diagram illustrating a configuration of an endoscope apparatus as an example of a medical device including an elastic tube according to an embodiment of the present invention.
- an endoscope apparatus 100 (medical device) includes an endoscope unit (medical device unit) 10 and a control device 20.
- the control device 20 drives and controls the endoscope unit 10. Details of the control device 20 will be described later.
- the endoscope section 10 has an elongated hollow cylindrical shape and an expandable elastic tube 1 in which air (gas) W is enclosed, and an inner end fixed to the distal end of the elastic tube 1.
- a non-expandable tube 3 having a hollow cylindrical shape connected to the other end side of the endoscope camera (medical instrument) 2 and the elastic tube 1 and enclosing air W (not shown), and the long axis direction of the elastic tube 1 And a non-stretchable body 4 having flexibility.
- the elastic tube 1 in FIG. 1 is in an expanded state due to the pressure of the air W injected from the control device 20. The expansion and contraction in the elastic tube 1 will be described later with reference to FIGS.
- the elastic tube 1 has an elastic tube main body 11, a fixing part 12 and a fixing part 13.
- the elastic tube body 11 is a main member that constitutes the elastic tube 1, and the distal end on the side where the endoscope camera 2 is fixed is sealed.
- the fixing portion 12 is provided at the sealed tip of the elastic tube main body 11 so that a medical instrument can be attached to the elastic tube 1.
- the medical instrument attached to the fixing unit 12 is not limited to the endoscope camera 2 and may be a catheter, a laser knife, or the like.
- the fixing portion 13 is provided in the major axis direction of the elastic tube 1 and enables the non-stretchable body 4 to be fixed.
- the fixing portion 12 and the fixing portion 13 are part of the elastic tube 1 and are made of the same material as the elastic tube 1.
- FIG. 2A is a perspective view showing the endoscope unit 10 of the endoscope apparatus 100 in FIG.
- FIG. 3 is a cross-sectional view taken along line AA of the endoscope unit 10 in FIG.
- the elastic tube main body 11 shown in FIG. 3 is composed of, for example, a silicone (polydimethylsiloxane added with a reinforcing agent such as silicon oxide) tube having an outer diameter of 2 mm, an inner diameter of 1 mm, and a length of 5 mm. From the control device 20 (see FIG. 1). It expands and contracts by the pressure of the air W injected into the elastic tube body 11.
- the shape of the elastic tube 1 is linear as shown by a solid line in FIG. Further, by increasing the pressure of the air W enclosed in the elastic tube main body 11, the elastic tube main body 11 expands as shown by a broken line in FIG.
- an LED lamp for illumination (not shown) can be attached adjacent to the fixed portion 12 to which the endoscope camera 2 is attached.
- illustration of the adhering part 13 is abbreviate
- the non-stretchable body 4 functions to prevent the elastic tube body 11 from expanding. That is, due to an increase in the pressure of the air W enclosed in the elastic tube main body 11, the elastic tube main body 11 is opposite to the fixing portion 13 to which the non-stretchable body 4 is attached and fixed (the elasticity on the (a) in FIG. 2). Even if the middle upper side of the tube main body 11 expands (indicated by P in the figure), it does not expand on the fixing part 13 side. Therefore, as indicated by a broken line in FIG. 2A, the elastic tube 1 can be curved downward in the figure (opposite side of the expansion portion P). For this reason, the bending angle of the elastic tube 1 can be arbitrarily changed by changing the pressure of the air W in the elastic tube main body 11. Details of the bending angle of the elastic tube 1 will be described later with reference to FIG.
- the stretchability of the non-stretchable body 4 only needs to be lower than that of the elastic tube main body 11.
- the elastic tube main body 11 is inflated on the side opposite to the fixing portion 13 and the elastic tube main body 11 is not expanded on the fixing portion 13 side. That's fine.
- a non-stretchable thread fishing line
- silicone of the same material as the elastic tube 1 may be used.
- the non-stretchable body 4 may be shared with a cable connected to a medical instrument.
- the non-stretchable body 4 shown in FIG. 2A may also be used as an electric cord that supplies power to the endoscope camera 2.
- the non-stretchable body 4 shown in FIG. 1 can also be used as a cable connecting the endoscope camera 2 and the camera monitor 6 along the endoscope unit 10.
- the cable connected to the non-stretchable body 4 and the medical instrument can be fixed inside the elastic tube body 11. Details will be described later with reference to FIG.
- the non-expandable tube 3 is made of a linear hard hollow body having the same shape as the elastic tube main body 11, that is, about 30 cm in length having the same outer diameter and inner diameter as the elastic tube main body 11, and can be made of acrylic resin. .
- connection tube 5 is a tube that connects the endoscope unit 10 and the control device 20. As shown in FIG. 2, the connection tube 5 is a hollow cylindrical tube having flexibility and non-expandability connected to the non-expansion tube 3.
- the connection tube 5 has substantially the same shape and length as the non-expanding tube 3 and is about 2 m in length.
- the connection tube 5 communicates with the elastic tube 1 and the non-expanding tube 3 and encloses air W as shown in FIG. 2A to 2C are provided on the side of the connection tube 5 of the non-expandable tube 3. Details of the flexible stand 7 will be described later with reference to FIG.
- FIG. 2B is a perspective view showing a medical device section 10a as an example when a catheter is attached as a medical instrument.
- the non-stretchable body 4 can be used as a cord that sends air to the catheter 2a.
- the balloon 2b of the catheter 2a is inflated by the air sent to the catheter 2a.
- the catheter 2a may be a guide wire type.
- the elastic tube 1 is used instead of the guide wire for guiding the direction in which the catheter advances. That is, a catheter 2 a is connected to the non-expandable tube 3 without the elastic tube 1, and the other end of the catheter 2 a on the side opposite to the non-expandable tube 3 is connected to the elastic tube 1 (on the side opposite to the fixed portion 12). One end) is connected.
- the gas sealed in the elastic tube main body 11 shall be inject
- FIG. 2 is a perspective view showing a medical device section 10b as an example when a laser knife is attached as a medical instrument.
- the non-stretchable body 4 can also be used as a cord for sending a signal for controlling the laser emitted from the laser knife 2c.
- the medical instrument attached to the elastic tube 1 may be an electric knife.
- the elastic tube 1 and the non-expandable tube 3 are integrated by bonding, and the hollow portion is in communication.
- air W is sealed in the elastic tube 1 from the connection tube 5 side via the non-expandable tube 3 by the control device 20.
- FIG. 4A is a cross-sectional view taken along the line BB of the elastic tube 1 in FIG.
- the figure shows the structure of the elastic tube 1 according to the first embodiment of the present invention.
- the non-stretchable body 4 is very thin as compared with the elastic tube main body 11.
- the outer diameter of the cross section of the elastic tube main body 11 is 1 cm
- the outer diameter of the cross section of the non-stretchable body 4 is 0.5 mm. Degree.
- the cross section of the non-stretchable body 4 is not limited to a circular shape, and if it is chamfered so as not to damage the human body when inserted into the body, or has a small size, It may be a polygonal shape such as a triangle or a quadrangle.
- the elastic tube 1 has a configuration in which a fixing portion 13 (not shown) is disposed on the outer peripheral surface (outside) of the elastic tube main body 11. For this reason, the non-stretchable body 4 is fixed to the outside of the elastic tube body 11.
- a fixing portion 13 not shown
- the non-stretchable body 4 is fixed to the outside of the elastic tube body 11.
- the non-stretchable body 4 (electric cord) is attached to the elastic tube 1.
- the non-inflatable tube 3 (see FIG. 1) is bonded to the side surface and led out of the endoscope portion 10.
- FIG. 4B is a view showing a modification of the elastic tube.
- This figure shows the structure of the elastic tube 1a according to the second embodiment of the present invention.
- the elastic tube 1a has a configuration in which a fixing portion 13 (not shown) is disposed on the inner peripheral surface (inside) of the elastic tube main body 11. For this reason, the non-stretchable body 4 is fixed inside the elastic tube body 11.
- the non-stretchable body 4 may also be used as a cable connected to a medical instrument.
- the cable connected to the non-stretchable body 4 and the medical instrument is fixed to the inside of the elastic tube main body 11, so that the surface of the elastic tube main body 11 is not uneven.
- the elastic tube 1a can be easily cleaned and disinfected, and can be easily reused.
- the cable connected to the non-stretchable body 4 and the medical instrument is fixed to the inside of the elastic tube body 11, so that the arrangement is protected by the elastic tube body 11.
- the damaged portion is protected by the elastic tube main body 11, so that the human body is less likely to be damaged.
- the human body may be damaged due to the damaged portion of the non-stretchable body 4. Is low.
- the cable connected to the medical instrument is an electrical cable
- adverse effects such as leakage due to the breakage of the electrical cable can be avoided in the human body.
- poured in the elastic tube main body 11 even if an electric cable is damaged, since electricity is hard to be conducted in the elastic tube main body 11, the bad influence of a leakage can be avoided in the elastic tube main body 11. .
- FIG. 4C is a cross-sectional view of the elastic tube 1a when the fixing portion 13 (not shown) is disposed on the inner peripheral surface (inside) of the elastic tube main body 11.
- FIG. 4C shows the structure of the elastic tube 1a according to the third embodiment of the present invention.
- a non-stretchable body 4 different from the cable connected to the medical instrument is fixed inside the elastic tube body 11.
- the cable 14 connected to the medical instrument is arrange
- FIG. 4 are diagrams showing still another modified example of the elastic tube.
- 4D to 4F show the structures of the elastic tubes 1b according to Examples 4 to 6 of the present invention, respectively.
- the elastic tube 1 b may be configured such that the fixing portion 13 is disposed inside the elastic body in the elastic tube main body 11.
- the elastic body constitutes the elastic tube main body 11 and is a thickness portion (shaded area in FIG. 4) from the inner peripheral surface to the outer peripheral surface of the elastic tube main body 11. If it demonstrates more concretely, the elastic tube 1b is the structure by which the adhering part 13 (not shown) is arrange
- the non-stretchable body 4 is fixed in a state of being embedded between the inner peripheral surface and the outer peripheral surface of the elastic tube body 11. That is, the elastic tube main body 11 shown in FIG. 4D is molded in a state in which the non-stretchable body 4 is integrated with the elastic tube main body 11 in advance, thereby fixing the non-stretchable body 4 to the elastic tube main body 11. can do.
- the non-stretchable body 4 may also be used with a cable 14 connected to a medical instrument, as shown in FIG.
- the non-stretchable body 4 When the non-stretchable body 4 is not used as a cable connected to a medical instrument, the non-stretchable body 4 is located between the inner peripheral surface and the outer peripheral surface of the elastic tube body 11 as shown in FIG.
- the cable 14 may be fixed in a state of being embedded in the cable, and the cable 14 may be disposed in the hollow interior of the elastic tube body 11.
- the non-stretchable body 4 or the cable 14 may be configured to be in contact with the outer peripheral surface and the inner peripheral surface of the elastic tube body 11, but in order to increase the mechanical strength of the elastic tube 1b, FIG. As shown to (f), it is desirable to arrange
- the cable connected to the non-stretchable body 4 and the medical instrument is embedded between the inner peripheral surface and the outer peripheral surface of the elastic tube main body 11, so that it is formed on the surface (outer peripheral surface) of the elastic tube main body 11. Unevenness does not occur. For this reason, the elastic tube 1b can be easily cleaned and disinfected, and can be easily reused.
- the cable connected to the non-expandable body 4 and the medical device is fixed between the inner peripheral surface and outer peripheral surface in the elastic tube main body 11, or the hollow inside of the elastic tube main body 11. Therefore, the arrangement is protected by the elastic tube body 11. For this reason, when a part of the cable connected to the non-stretchable body 4 and the medical instrument is damaged for some reason, the damaged portion is protected by the elastic tube main body 11, so that the human body is less likely to be damaged.
- the human body may be damaged by the damaged portion of the non-stretchable body 4. Is low.
- the cable connected to the medical instrument is an electrical cable
- adverse effects such as leakage due to the breakage of the electrical cable can be avoided in the human body.
- poured in the elastic tube main body 11 even if an electric cable is damaged, since electricity is hard to be conducted in the elastic tube main body 11, the bad influence of a leakage can be avoided in the elastic tube main body 11. .
- the entire outer peripheral surface of the cable connected to the non-stretchable body 4 or the medical instrument is fixed to the elastic tube body 11.
- the bending angle ⁇ of the elastic tube 1b changes at a constant rate corresponding to the pressure P of the air inside the hollow of the elastic tube body 11. Therefore, there is an advantage that the bending angle ⁇ of the elastic tube body 11 can be easily controlled. This point will be described later with reference to FIG.
- FIG. 4 are diagrams showing still other modified examples of the elastic tube.
- 4 (g) to (i) show the structures of the elastic tubes 1c according to Embodiments 7 to 9 of the present invention, respectively.
- the elastic tube may be configured in combination with at least one other elastic tube made of an elastic body or a mesh tube-like sheet (see the network structure shown in FIG. 6B). That is, the elastic tube may have a plurality of layer structures made of anisotropic elastic elastic bodies such as a plurality of elastic tubes or a mesh shape. Even with a single elastic tube, it is possible to give elasticity to the elastic tube by making the tube several layers, winding a mesh tube sheet, or embedding the mesh tube sheet in the tube.
- the bending operation can be controlled with high accuracy. This is particularly effective when it is desired to perform equal bending at a plurality of locations (for example, bending at 90 ° in 2 locations or 60 ° in 3 locations and bending 180 °).
- Example 7 (G) of FIG. 4 shows the structure of the elastic tube 1c which concerns on Example 7 of this invention.
- This figure is a cross-sectional view of a configuration in which another elastic tube is wound around the outer periphery of the elastic tube 1b shown in FIG.
- the elastic tube 1c has another elastic tube 1k on the outer periphery of the elastic tube 1b, thereby suppressing the expansion in the circumferential direction (lateral direction) of the tube that does not contribute to bending and directly affecting the control of the bending angle. It is possible to produce a special effect that the expansion in the direction (longitudinal direction) is promoted and bending can be effectively performed. That is, the elastic tube 1c has anisotropic expansion / contraction characteristics with respect to the bending direction.
- the outer peripheral tube may not have a tube shape as long as it has elasticity.
- the outermost periphery is a tube having a flat surface.
- the elastic tube has directionality in tension.
- the circumferential direction of the tube has a function of temporarily suppressing expansion of the inner tube by having a certain amount of tension.
- the long axis direction of the tube is desirably a structure or material that can be extended (bent) without applying a load as much as possible according to the expansion of the internal tube.
- the number of elastic tubes arranged on the outer periphery is 1, but the number is not limited to this, and a plurality of elastic tubes may be arranged on the outer periphery.
- a stepwise bending operation caused by the tension of the outer peripheral tube can be performed, so that the degree of bending at the plurality of portions can be made uniform.
- FIG. 9B shows a graph of the relationship between the bending angle and the bending angle.
- FIG. 9A when the inside of the elastic tube is pressurized, the elastic tube initially has tension, so it does not expand against the pressure, but when the internal pressure exceeds this tension. Begins to expand, and the cross-sectional area increases and begins to bend. This bending operation depends on the thickness of the elastic tube and the elastic modulus of the material. For example, as shown in FIGS.
- a soft tube starts bending from a low pressure and bends greatly
- a hard tube starts bending from a relatively high pressure and bends relatively small. Therefore, the bending operation characteristics can be arbitrarily set by arbitrarily setting the structure and the material configuration.
- (c) of FIG. 9 is a graph of the relationship between the internal pressure of the elastic tube 1b and the cross-sectional area of the hollow portion in the elastic tube 1c shown in (g) of FIG. 4, and (d) of FIG. It is a graph which shows the relationship between the internal pressure of the elastic tube 1b, and a bending angle.
- the relationship between the pressure and the bending angle is a stepwise bending operation as shown in FIG. That is, the elastic tube 1c exhibits a stepwise expansion / contraction characteristic with respect to the magnitude of the internal pressure. Since the above bending operation depends not only on the elastic tube 1b but also on the size and thickness of the elastic tube 1k and the elastic modulus of the material, the bending operation characteristics can be set by arbitrarily setting the structure and the material configuration. Can be set arbitrarily.
- the stepwise bending operation of the elastic tube 1c as described above is realized not only when the internal pressure of the elastic tube 1b is increased (when increased), but also when the pressure is decreased (decreased) or when the pressure is reduced. To do.
- the elastic tube 1k is provided on the outer periphery of the elastic tube 1b, so that the expansion in the tube peripheral direction (lateral direction) that does not contribute to bending is suppressed, and the long axis direction (vertical direction) that directly affects the control of the bending angle. Direction) can be promoted, and a special effect can be produced such that bending can be performed effectively. That is, the elastic tube 1c has anisotropic expansion / contraction characteristics with respect to the bending direction. Moreover, since the useless expansion
- the elastic tube 1k arranged on the outer periphery may be provided with an appropriate play with an interval from the elastic tube 1b, and the behavior of this stepwise bending operation may be adjusted.
- the bending motion may be adjusted by changing each elastic modulus.
- the elastic modulus can be changed by changing the material or by changing the wall thickness. For example, it is desirable to reduce the load against bending by using a material that is easily stretched toward the outer periphery or using a thin material.
- the cross-section of the outer tube has a corrugated structure, and by applying almost no tension until this corrugation spreads, the same effect as hollowing can be obtained, and the area of the hollow portion can be reduced.
- the outer diameter of the bending device may be reduced.
- some of the outer peripheral elastic tubes may have a bellows structure (see FIG. 6A).
- a bellows structure see FIG. 6A.
- the pressure for starting the bending may be adjusted by appropriately combining the various structures described above, and the bending operation of each bent portion may be performed simultaneously. You may comprise so that it may bend in order from this bending location.
- FIG. 4 is a cross-sectional view of a configuration in which, for example, a mesh tube-shaped elastic sheet (see FIG. 6B) is wound around the outer periphery of the elastic tube 1b shown in FIG.
- a mesh tube-shaped elastic sheet see FIG. 6B
- the crossing angle of the mesh in the vertical and horizontal directions and giving directionality to the stretchability
- the expansion in the circumferential direction (lateral direction) of the tube that does not contribute to bending is more effectively suppressed
- the bending angle It is possible to promote the expansion in the major axis direction (longitudinal direction) that directly affects the control, and to perform bending more effectively.
- it has directionality in stretchability, it is not limited to a mesh shape.
- a plurality of meshed cylindrical elastic sheets may be wound, and the bending operation may be appropriately adjusted by changing the respective elastic modulus.
- FIG. 2 is a cross-sectional view of a configuration in which a mesh tube-shaped elastic sheet is embedded in the elastic tube body 11.
- the elastic tube 1c is a structure by which an elastic sheet is arrange
- seat) single was shown, you may make it the structure which embed
- the elastic tube itself can have stepwise expansion / contraction characteristics having a plurality of steps. Since they are integrated, an elastic tube having stepwise expansion / contraction characteristics can be configured in a compact manner, and the diameter can be further reduced, and further, the controllability of expansion / contraction can be improved.
- non-stretchable body 4 may be combined with a cable 14 connected to a medical instrument as shown in FIG.
- the non-stretchable body 4 when the non-stretchable body 4 is not used as a cable connected to a medical instrument, the non-stretchable body 4 is composed of the inner peripheral surface and the outer peripheral surface of the elastic tube main body 11 as in the diagram shown in FIG. And the cable 14 may be disposed in the hollow inside of the elastic tube main body 11.
- the non-stretchable body 4 or the cable 14 and the elastic sheet may be configured to be in contact with the outer peripheral surface and the inner peripheral surface of the elastic tube main body 11, but in order to increase the mechanical strength of the elastic tube 1b, FIG. As shown in FIG. 4 (d) to FIG. 4 (d), it is desirable that the elastic tube main body 11 is disposed with a space between the outer peripheral surface and the inner peripheral surface.
- the cable 14 and the elastic sheet connected to the non-stretchable body 4 or the medical instrument are embedded between the inner peripheral surface and the outer peripheral surface of the elastic tube main body 11, and thus the surface of the elastic tube main body 11 ( There are no irregularities on the outer peripheral surface. For this reason, the elastic tube 1c can be easily cleaned and disinfected, and can be easily reused.
- the cable 14 connected to the non-stretchable body 4 and the medical instrument is fixed between the inner peripheral surface and the outer peripheral surface of the elastic tube main body 11 or inside the hollow of the elastic tube main body 11. Therefore, the arrangement is protected by the elastic tube body 11 and the added elastic sheet. For this reason, when a part of the cable 14 connected to the non-stretchable body 4 and the medical instrument is damaged for some reason, the damaged portion is protected by the elastic tube main body 11 and the elastic sheet, so that the human body may be damaged. Lower.
- the above-described adverse effects on the human body due to the cable connected to the medical instrument can be avoided.
- the vicinity of the medical instrument fixed to the elastic tube 1 can be made compact, the cable connected to the medical instrument does not interfere with the medical procedure.
- FIG. 5 are diagrams showing still another modified example of the elastic tube.
- FIG. 5A shows the structure of an elastic tube 1d according to Example 10 of the present invention.
- This figure is a cross-sectional view of a configuration in which another elastic tube 1m is wound around the outer periphery of the elastic tube 1c shown in FIG.
- the elastic tube 1d has another elastic tube 1m on the outer periphery of the elastic tube 1c, thereby suppressing expansion in the circumferential direction (lateral direction) of the tube that does not contribute to bending, and directly affecting the control of the bending angle. It is possible to produce a special effect that the expansion in the direction (longitudinal direction) is promoted and bending can be effectively performed. Moreover, since the useless expansion
- the elastic tube 1m arranged on the outer periphery may be provided with an appropriate play with an interval from the elastic tube 1c, and the behavior of this stepwise bending operation may be adjusted.
- the elastic tubes 1c and 1m The bending motion may be adjusted by changing each elastic modulus.
- the elastic modulus can be changed by changing the material or by changing the wall thickness. For example, it is desirable to reduce the load against bending by using a material that is easily stretched toward the outer periphery or using a thin material.
- the cross-section of the outer tube has a corrugated structure, and by applying almost no tension until this corrugation spreads, the same effect as hollowing can be obtained, and the area of the hollow portion can be reduced.
- the outer diameter of the bending device may be reduced.
- some of the outer peripheral elastic tubes may have a bellows structure (see FIG. 6A).
- a bellows structure see FIG. 6A.
- FIG. 5B shows the structure of the elastic tube 1d according to Example 11 of the present invention.
- This figure is a cross-sectional view of a configuration in which another elastic tube 1m is wound around the outer periphery of the elastic tube 1c shown in FIG.
- the elastic tube 1d has another elastic tube 1m on the outer periphery of the elastic tube 1c, thereby suppressing expansion in the circumferential direction (lateral direction) of the tube that does not contribute to bending, and directly affecting the control of the bending angle. It is possible to produce a special effect that the expansion in the direction (longitudinal direction) is promoted and bending can be effectively performed.
- Example 12 shows the structure of the elastic tube 1d which concerns on Example 12 of this invention.
- 4 is a cross-sectional view of a configuration in which another elastic tube 1m is wound around the outer periphery of the elastic tube 1c shown in FIG. 4 (i) in which a mesh tube-shaped elastic sheet is embedded in the elastic tube main body 11.
- the elastic tube 1d has another elastic tube 1m on the outer periphery of the elastic tube 1c, thereby suppressing expansion in the circumferential direction (lateral direction) of the tube that does not contribute to bending, and directly affecting the control of the bending angle. It is possible to produce a special effect that the expansion in the direction (longitudinal direction) is promoted and bending can be effectively performed.
- a stepwise bending operation can be performed by appropriately setting the contraction characteristics of the elastic modulus of the elastic tube 1m and the mesh-like elastic sheet.
- FIG. 4 is a cross-sectional view of a configuration in which an outer peripheral tube having a corrugated cross section is wound around the outer periphery of the elastic tube 1b shown in FIG. 4D, and another outer peripheral tube is wound around the outer periphery.
- the cross section of the outer tube has a corrugated structure, and by applying almost no tension until this corrugation spreads, the same effect as hollowing can be obtained and the area of the hollow part can be reduced.
- the outer diameter of the bending device may be reduced.
- the above-described endoscope unit 10 may be configured by a multi-joint bent portion 30 in which a plurality of bent portions 31 and non-bent portions 32 are alternately provided. good.
- FIG. 11A shows a state of the multi-joint bent portion 30 when the plurality of bent portions 31 are not bent.
- (b) and (c) of FIG. 11 show a state of the multi-joint bent portion 30 when each of the plurality of bent portions 31 is bent.
- a single bent portion 31 is provided around the single elastic tube main body 11. It is preferable to use an elastic tube provided with a plurality of outer peripheral tubes (or elastic sheets). This makes it possible to perform a stepwise bending operation caused by the tension of the outer peripheral tube, so that the degree of bending of the plurality of bent portions 31 can be made uniform.
- the multi-joint bending portion 30 is bent at a plurality of locations so that the organ or the like does not interfere with the operation, whereby the avoidance operation can be performed on the treatment instrument such as the organ or forceps.
- the shaft of the elastic tube on the other end side which is different from one end where the camera is installed, is rotated while the avoidance operation of the articulated bending portion 30 is performed.
- the camera tip can be moved while the affected part is always in the visual field, so that the affected part once captured in the visual field is not lost. Therefore, there is a special effect that the time (surgical time) from losing sight to searching for the affected part can be shortened.
- the control device 20 includes a piston (atmospheric pressure varying unit) 21 and a syringe 22 (FIG. 7) that change the pressure of air (gas) W in the elastic tube 1, an air pressure sensor 23 that detects the pressure of air W, and a piston 21.
- a piston atmospheric pressure varying unit
- a syringe 22 FIG. 7
- the gas sealed in the elastic tube 1 is not limited to air, and any gas may be used as long as it does not contaminate the medical treatment site.
- the piston 21, the piston driving unit 24, and the piston control unit 26 are used as an example of the atmospheric pressure variable unit, but an atmospheric pressure adjusting valve (not shown) or the like may be used instead.
- an atmospheric pressure adjusting valve (not shown) or the like may be used instead.
- the microphone 25 is used as an example of the instruction receiving unit, a foot switch (not shown) or the like may be used instead.
- FIG. 10 is a front view showing a medical treatment (surgery) situation (an example).
- the piston drive unit 24 is controlled by the piston control unit 26 based on the voice of the operator 105 detected by the microphone 25, and the air pressure in the elastic tube 1 is changed using the piston 21 and the syringe 22. Change. Details of the piston 21 and the syringe 22 will be described later with reference to FIG.
- the endoscope camera 2 can be bent upward or downward on the display screen of the camera monitor 6, when the operator 105 utters the voice “up”, the display screen of the camera monitor 6 is displaying. Start moving to show the top direction of the image. Then, the movement of the display screen on the camera monitor 6 is stopped by the voice “stop” by the operator 105. When the voice of the operator 105 is “down”, the display screen on the camera monitor 6 moves downward in the displayed image.
- the position of the flexible stand 7 needs to be adjusted in advance so that the bending direction of the elastic tube 1 is in the left-right direction.
- the endoscope unit 10 is maintained at a predetermined position by a flexible stand 7 attached to the operating table 8, and the position is manually adjusted by the operator 105.
- the elastic tube 1 used in the medical procedure shown in FIG. 10 can be replaced with a new elastic tube 1 (disposable). Alternatively, after the medical treatment is completed, the used elastic tube 1 can be reused (reused) by cleaning and disinfecting it.
- the elastic tube 1 is reused, in order to prevent the use of the deteriorated elastic tube 1, the upper limit number of times of use or the upper limit number of bending of the elastic tube 1 is set in advance in the control device 20, The elastic tube 1 exceeding the number of times needs to be unusable.
- FIG. 7 shows a specific structure of the piston 21 and the syringe 22 that variably control the air pressure.
- the piston 21 is slidably inserted into the syringe 22 connected to the connection tube 5.
- the piston driving part 24 is a screw part 27 having one end side (left side in the figure) fixed to the mounting part 29 of the base 28 and the other end side (right side in the figure) connected to the piston driving part 24.
- the screw portion 27 is screwed.
- the screw portion 27 is rotated forward or backward, whereby the piston 21 moves in the left-right direction in the drawing.
- the piston controller 24 controls the forward or reverse rotation and the rotational speed of the piston drive unit 24.
- FIG. 8 is a diagram showing the bending characteristics of the elastic tube according to the embodiment of the present invention.
- the horizontal axis in FIG. 8 is the pressure (P [kPa]) of the air W in the elastic tube body 11, and the vertical axis represents the bending angle ( ⁇ [°]) of the elastic tube body 11.
- FIG. 8A is a diagram showing the relationship between the pressure P and the bending angle ⁇ when the elastic tube shown in FIGS. 4A to 4C is used. As shown in FIG. 8A, the relationship between the pressure P and the bending angle ⁇ is a hysteresis characteristic (nonlinear characteristic).
- the bending angle ⁇ of the elastic tube 1 gradually increases monotonously as the air pressure increases up to the pressure of 230 kPa.
- the pressure P passes around 230 kPa
- the bending angle ⁇ of the elastic tube 1 increases rapidly as the pressure P increases.
- the pressure P of the air W in the elastic tube main body 11 is decreased (during depressurization)
- the bending angle ⁇ of the elastic tube 1 corresponds to the decrease in the pressure P until the pressure P reaches 230 kPa. Slowly and monotonously decrease.
- the bending angle ⁇ of the elastic tube body 11 rapidly decreases as the pressure P decreases until the pressure P reaches 170 kPa.
- the bending angle ⁇ of the elastic tube body 11 gradually decreases monotonously according to the decrease in the pressure P.
- the display image displayed on the camera monitor 6 moves at a constant rate.
- the bending angle of the elastic tube body 11 can be changed.
- FIG. 8B is a diagram showing the relationship between the pressure P and the bending angle ⁇ when another modification of the elastic tube shown in FIGS. 4D to 4F is used. As shown in FIG. 8B, the relationship between the pressure P and the bending angle ⁇ is substantially linear.
- the bending angle ⁇ of the elastic tube 1b is approximately linear with an increase in air pressure from a pressure of about 100 kPa to about 260 kPa. To increase. Further, when the pressure P of the air W in the elastic tube main body 11 is decreased (during pressure reduction), the bending angle ⁇ of the elastic tube 1b corresponds to the decrease in the pressure P until the pressure P is in the vicinity of 260 kPa to 100 kPa. Decreases linearly.
- the bending characteristic of the elastic tube main body 11 as shown in FIG. 8B is set in the piston controller 26 in advance, the display image displayed on the camera monitor 6 moves at a constant rate.
- the bending angle of the elastic tube body 11 can be changed.
- the bending characteristic of the elastic tube main body 11 as shown in FIG. 8B is linear, when the elastic tube main body 11 having the linear characteristic is used, the setting of the piston control unit 26 is as shown in FIG. It becomes simpler than the case where the elastic tube 1 which has a hysteresis characteristic as shown to (a) of is used. For this reason, there exists an advantage that the bending angle of the elastic tube main body 11 is easy to control.
- the elastic tube 1 may be configured to be automatically operated.
- the endoscope camera 2 shown in FIG. 1 when the endoscope camera 2 shown in FIG. 1 is used as a medical instrument, an image photographed by the endoscope camera 2 is simultaneously displayed while an image photographed by the endoscope camera 2 is displayed on the camera monitor 6. It is good also as a structure (not shown) acquired and analyzed in the apparatus 20.
- FIG. The control device 20 automatically adjusts the pressure of the gas sealed in the elastic tube body 11 according to the analyzed information. Therefore, the bending angle of the endoscope camera 2 can be automatically changed. It is assumed that the control device 20 stores in advance image data indicating the progress of the medical procedure. Further, the control device 20 may change the bending angle of the endoscope camera 2 using the hysteresis characteristic shown in FIG.
- the elastic tube 1 may be manually operated using a tablet terminal (not shown).
- a tablet terminal for example, when an assistant (not shown) of an operator performing medical treatment (for example, the operator 105 in FIG. 10) operates the tablet terminal to change the bending angle of the medical device, the assistant is at a position away from the operator.
- the tablet terminal can be operated. For this reason, the operation of the assistant does not interfere with the medical treatment action of the surgeon, and the surgeon can concentrate on the medical treatment.
- an operator for example, the operator 105 in FIG. 10) may operate the tablet terminal to change the bending angle of the medical device. In this case, an actual medical procedure can be performed by a robot (not shown) instead of the operator.
- An elastic tube (1) according to the first aspect of the present invention is provided with an elastic tube body (11) having an elongated hollow cylindrical shape and a sealed one end of the elastic tube body, and a medical instrument (endoscopic camera). 2, a fixing part (12) to which the catheter 2a and the laser knife 2c) can be attached, and a fixing part (13) to which a flexible non-stretchable body (4) can be fixed in the major axis direction of the elastic tube main body.
- the medical device (endoscope apparatus 100) is characterized in that it is expanded or contracted on the opposite side of the non-stretchable body by controlling the pressure of the gas injected into the elastic tube main body. ).
- the convenience in the medical field is remarkably superior in that it is disposable and does not invade the human body. It is expected to spread widely.
- the elastic tube (1) according to aspect 2 of the present invention is the elastic tube (1) according to aspect 1, in which the fixing portion fixes the non-stretchable body made of a material having lower elasticity than the elastic tube main body to the elastic tube main body. May be.
- the non-stretchable body made of a material having lower elasticity than the elastic tube main body is fixed to the elastic tube main body.
- the non-stretchable body of the silicone material is easily fixed to the elastic tube body.
- a polyamide fiber is used for the non-stretchable body, it is difficult to adhere to an elastic tube made of a silicone material. Therefore, this is effective when the non-stretchable body is easily removed from the elastic tube.
- the fixing portion may fix the cable connected to the medical device to the elastic tube body as the non-stretchable body.
- the cable connected to the medical instrument is fixed to the elastic tube body.
- the elastic tube can be bent by using an object used during medical treatment. Therefore, the elastic tube has a simple structure that does not have a new non-stretchable body, and can be manufactured easily and inexpensively.
- the elastic tube (1) according to aspect 4 of the present invention is the elastic tube (1) according to any one of the aspects 1 to 3, wherein the fixing portion is disposed between the inner peripheral surface and the outer peripheral surface of the elastic tube main body. Good.
- the entire outer peripheral surface of the cable connected to the non-stretchable body or the medical instrument is fixed to the elastic tube body. For this reason, the bending angle of the elastic tube changes at a constant rate in accordance with the adjustment of the pressure P of the air inside the hollow of the elastic tube main body. Therefore, there is an advantage that it is easy to control the bending angle of the elastic tube body.
- the fixing portion may be disposed inside the hollow of the elastic tube main body.
- the cable connected to the non-stretchable body 4 and the medical instrument is fixed to the inside of the elastic tube main body 11, so that the surface of the elastic tube main body 11 is not uneven.
- the elastic tube 1a can be easily cleaned and disinfected, and can be easily reused.
- the cable connected to the non-stretchable body 4 and the medical instrument is fixed to the inside of the elastic tube body 11, so that the arrangement is protected by the elastic tube body 11.
- the damaged portion is protected by the elastic tube main body 11, so that the human body is less likely to be damaged.
- the human body may be damaged due to the damaged portion of the non-stretchable body 4. Is low.
- the cable connected to the medical instrument is an electrical cable
- adverse effects such as leakage due to the breakage of the electrical cable can be avoided in the human body.
- poured in the elastic tube main body 11 even if an electric cable is damaged, since electricity is hard to be conducted in the elastic tube main body 11, the bad influence of a leakage can be avoided in the elastic tube main body 11. .
- the elastic tube (1) according to aspect 6 of the present invention is the above-described aspect 1, 2, or 4, wherein the elastic tube main body includes a cable connected to the medical instrument disposed in a hollow inside of the elastic tube main body. Also good.
- the cable connected to the medical device is elastic. It arrange
- the elastic tube (1) according to Aspect 7 of the present invention is the elastic tube (1) according to any one of Aspects 1 to 6, wherein the elastic tube is easily expanded and contracted in the major axis direction compared to the peripheral direction. It may be a tube showing different anisotropic stretch characteristics.
- the elastic tube (1) according to the aspect 8 of the present invention is the elastic tube (1) according to the aspect 7 described above, wherein the elastic tube exhibiting different anisotropic expansion and contraction characteristics has a structure in which a mesh-like elastic body is fixed. Also good.
- the elastic tube (1) according to the ninth aspect of the present invention is the tube according to any one of the first to sixth aspects, wherein the elastic tube exhibits a stepwise expansion / contraction characteristic with respect to the magnitude of the internal pressure. Also good.
- the degree of bending at a plurality of locations can be made uniform.
- the elastic tube (1) according to the tenth aspect of the present invention is the elastic tube (1) according to any one of the seventh to ninth aspects, wherein the elastic tube is a plurality of elastic tubes or an anisotropic stretchable elasticity such as a mesh. You may have the several layer structure which consists of a body.
- the plurality of elastic tubes may be composed of elastic tubes having different elastic moduli or anisotropic stretchable elastic bodies having different elastic moduli. .
- a control device (20) according to aspect 12 of the present invention is a control device that controls expansion and contraction of the elastic tube according to aspect 1, and includes an instruction receiving unit (microphone) that receives an instruction to expand or contract the elastic tube. 25) and an atmospheric pressure variable unit (piston 21, piston drive unit 24, piston control unit 26) that varies the pressure of the gas injected into the hollow inside of the elastic tube body based on the instruction received by the instruction receiving unit. ).
- the distal end portion of the medical device is operated by the control device, a surgeon (camera assistant 104) for operating the distal end portion of the medical device is unnecessary, and the surgeon (assistant 104) operates. Does not interfere with medical procedures (surgery) performed by another surgeon (surgeon 105). Therefore, the surgeon (operator 105) can concentrate on the medical procedure (surgery).
- the pressure varying unit may be automatically operated according to information acquired by the medical instrument.
- the elastic tube is automatically bent by the automatic operation of the atmospheric pressure variable section.
- an image taken by the endoscopic camera is displayed on the camera monitor (6), and at the same time, an image taken by the endoscopic camera is acquired and analyzed by the control device.
- the configuration is as follows. Then, according to the analysis information of the control device, the atmospheric pressure variable unit is automatically operated, and the pressure of the gas enclosed in the elastic tube body is automatically adjusted, so that the bending angle of the endoscope camera is automatically changed. be able to. It is assumed that image data indicating the progress of the medical procedure is stored in the control device in advance.
- the medical instrument is automatically moved, so that the surgeon can concentrate on the medical procedure.
- the medical device (100) according to aspect 14 of the present invention may include the elastic tube according to aspect 1 and the control device according to aspect 12.
- the medical device (100) according to the aspect 15 of the present invention may include the endoscope camera (2), the catheter (2a), the laser knife (2c), or the electric knife as the medical instrument in the aspect 14. .
- a medical device having both the advantages of the elastic tube according to the present invention and the advantages of the control device according to the present invention can be provided.
- the present invention can also be expressed as follows.
- the elastic tube according to the present invention may have different anisotropic stretch characteristics with respect to the bending direction.
- the elastic tube having different stretch characteristics with respect to the bending direction may have an anisotropic stretchable elastic body such as a mesh.
- the elastic tube according to the present invention may have a stepwise expansion / contraction characteristic with respect to the internal pressure.
- the elastic tube according to the present invention may be composed of a plurality of layer structures made of anisotropic elastic materials such as a plurality of elastic tubes or mesh.
- the elastic tube which concerns on this invention may be comprised by the nested structure which consists of an elastic body of anisotropic elasticity, such as several elastic tubes or mesh shape.
- the plurality of elastic tubes may be composed of elastic tubes having different elastic moduli or anisotropic stretch elastic bodies such as meshes having different elastic moduli.
- the endoscope apparatus has an elongated hollow cylindrical shape and an expandable elastic tube sealed with air, and the distal end portion of the elastic tube portion is sealed and fixed to the distal end portion.
- a non-expanding tube having a hollow cylindrical shape that is connected to the other end of the elastic tube portion and sealed with air, and a non-expandable tube that is fixed to the elastic tube portion in the length direction.
- a telescopic body a flexible and non-expandable hollow cylindrical connection tube connected to the non-expandable tube portion, and variably controlling the air pressure in the elastic tube via the connection tube and the non-expandable tube
- a control unit that controls the air pressure in the elastic tube, and the air pressure causes the elastic tube to expand and contract on the opposite side of the non-stretchable body.
- The may represent elastic tube as the endoscope apparatus is curved to any angle Ri.
- the control unit includes a piston and a syringe that change the air pressure in the elastic tube, an air pressure sensor that detects the air pressure, The piston is operated in the syringe to change the air pressure, the microphone for inputting the operator's voice, the voice signal inputted by the microphone and the detection signal of the air pressure sensor are inputted, and the piston A piston control unit that controls the drive unit, and the piston control unit is controlled by the piston control unit according to an operator's voice to change the air pressure in the elastic tube.
- the non-stretchable body may be made of a polyamide fiber in the endoscope apparatus having the above configuration.
- the endoscope apparatus according to the present invention may be an electric cord in which the non-stretchable body supplies power to the camera in the endoscope apparatus having the above configuration.
- the present invention can be suitably used for an elastic tube, a control device, and a medical device.
- it can be used for medical devices equipped with an endoscope camera, a catheter, a laser knife, and an electric knife in a medical field.
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Abstract
Description
(1)キズが目立たないため美容的に優れている。
(2)手術後の痛みが少ない。
(3)回復が早いため従来の手術方法より短い入院期間(2~3日)で退院できる。よって医療費が抑制できる。
(4)身体への負担が少ないため体力が低下した患者(高齢者)でも安全に手術が受けられる。
(1)体外で人同士、手術器具同士が接触し邪魔しあう。
(2)術者とカメラ助手の接触。
(3)鉗子と内視鏡カメラの接触。
図1は、本発明実施の形態に係る弾性チューブを備えた医療機器の一例として、内視鏡装置の構成を示す図である。図1において、内視鏡装置100(医療機器)は、内視鏡部(医療機器部)10および制御装置20を備える。制御装置20は、内視鏡部10を駆動制御する。制御装置20の詳細については、後述する。
ここで、図2および図3を用いて弾性チューブ本体11の膨張について説明する。図2の(a)は、図1における内視鏡装置100の内視鏡部10を示す斜視図である。図3は、図2の(a)における内視鏡部10のA‐A線断面図である。図3に示す弾性チューブ本体11は、例えば外径2mm、内径1mm、長さ5mmのシリコーン(酸化ケイ素等の強化剤を添加したポリジメチルシロキサン)チューブよりなり、制御装置20(図1参照)から弾性チューブ本体11内に注入される空気Wの圧力によって膨張および収縮する。弾性チューブ本体11内に封入されている空気Wの圧力が常圧(1気圧)の場合、弾性チューブ1の形状は、図2の(a)において実線で示されるように、直線状である。また、弾性チューブ本体11内に封入された空気Wの圧力を増加させることにより、図2の(a)において破線で示されるように、弾性チューブ本体11は膨張する。
図2の(b)は、医療器具としてカテーテルが取り付けられた場合の一例として、医療機器部10aを示す斜視図である。カテーテル2aが固定部12に取り付けられた場合、非伸縮体4は、カテーテル2aに空気を送るコードで兼用できる。図2の(b)に示すように、カテーテル2aに送られた空気によりカテーテル2aのバルーン2bが膨らむ。
図3に示すように、弾性チューブ1および非膨張チューブ3は接着により一体化され、中空部分は連通している。当該中空部分は、制御装置20により、接続チューブ5側から非膨張チューブ3を介して弾性チューブ1に空気Wが封入されている。
図4の(a)は、図3における弾性チューブ1のB‐B線断面図である。同図は、本発明の実施例1に係る弾性チューブ1の構造を示している。非伸縮体4は、弾性チューブ本体11と比較して非常に細いものであり、例えば、弾性チューブ本体11における断面の外径が1cmの場合、非伸縮体4における断面の外径は0.5mm程度である。なお、非伸縮体4における断面は、円形状に限定されるものではなく、体内に挿入された際に人体を傷つけないように角の面取りが施されていたり、小さなサイズのものであれば、三角形または四角形など多角形の形状であってもよい。
図4の(b)は、弾性チューブの変形例を示す図である。同図は、本発明の実施例2に係る弾性チューブ1aの構造を示している。弾性チューブ1aは、弾性チューブ本体11の内周面(内側)に固着部13(不図示)が配置される構成である。このため、非伸縮体4は、弾性チューブ本体11の内側に固着される。なお、非伸縮体4は、医療器具に接続されたケーブルで兼用してもよい。
また、医療器具に接続されたケーブルとは異なる非伸縮体4が、図4の(a)および(b)に示されるように弾性チューブ本体11に固着される場合、医療器具に接続されたケーブルは弾性チューブ本体11の中空内部に配置されてもよい。例えば、図4の(c)は、弾性チューブ本体11の内周面(内側)に固着部13(不図示)が配置される場合における弾性チューブ1aの断面図である。同図は、本発明の実施例3に係る弾性チューブ1aの構造を示している。この場合、医療器具に接続されたケーブルとは異なる非伸縮体4が、弾性チューブ本体11の内側に固着されている。そして、医療器具に接続されたケーブル14が弾性チューブ本体11の中空内部に配置される。
図4の(d)~(f)は、弾性チューブの更に他の変形例を示す図である。図4の(d)~(f)は、それぞれ、本発明の実施例4~6に係る弾性チューブ1bの構造を示している。弾性チューブ1bは、固着部13が弾性チューブ本体11における弾性体内部に配置されるように構成してもよい。弾性体は、弾性チューブ本体11を構成するものであり、弾性チューブ本体11における内周面から外周面までの厚み部分(図4の斜線箇所)である。より具体的に説明すれば、弾性チューブ1bは、弾性チューブ本体11における内周面と外周面との間に固着部13(不図示)が配置される構成である。このため、例えば図4の(d)に示すように、非伸縮体4は、弾性チューブ本体11における内周面と外周面との間に埋め込まれる状態で固着される。すなわち、図4の(d)に示す弾性チューブ本体11は、非伸縮体4が弾性チューブ本体11と予め一体化された状態で成型されることにより、非伸縮体4を弾性チューブ本体11に固着することができる。なお、非伸縮体4は、図4の(e)に示すように、医療器具に接続されたケーブル14で兼用してもよい。
図4の(g)は、本発明の実施例7に係る弾性チューブ1cの構造を示す。同図は、図4の(d)に示す弾性チューブ1bの更に外周に別の弾性チューブを巻いた構成の断面図である。弾性チューブ1cは、弾性チューブ1bの外周にさらに別の弾性チューブ1kがあることにより、屈曲に寄与しないチューブの周囲方向(横方向)の膨張を抑制し、湾曲角度の制御に直接影響する長軸方向(縦方向)の膨張を促し、屈曲を効果的に行うことができるといった特段の効果を生むことができる。すなわち、弾性チューブ1cは、屈曲方向に対する異方伸縮特性を有している。また、無駄なチューブの周囲方向の膨張が抑えられるので、伸縮の繰り返しで生じる機械的ストレスによるチューブの劣化も防ぐことができる。なお、外周チューブは、弾性をもったものであれば、チューブ状でなくても構わない。但し、洗浄容易性を高めるため、最外周は平坦な表面のチューブであることが望ましい。また、弾性チューブは、張力に方向性を有していることが望ましい。チューブの周囲方向は、ある程度の張力を有することで、一時的に内部チューブの膨張を抑える機能を持つ。チューブの長軸方向は、内部チューブの膨張に応じて、負荷をできるだけ与えないで、伸びる(屈曲する)ことができる構造や材料とすることが望ましい。
次に、図4の(h)は、本発明の実施例8に係る弾性チューブ1cの構造を示す。同図は、図4の(d)に示す弾性チューブ1bの更に外周に、例えば網目筒状の弾性シート(図6の(b)参照)を巻いた構成の断面図である。網目の交差角度を縦方向と横方向で変え、伸縮性に方向性を持たせることにより、より効果的に、屈曲に寄与しないチューブの周囲方向(横方向)の膨張を抑制し、湾曲角度の制御に直接影響する長軸方向(縦方向)の膨張を促し、屈曲を更に効果的に行うことができる。伸縮性に方向性を持たせるものであれば、網目状に限定するものではない。また、上述した内容と同様に、この網目筒状の弾性シートを複数巻いてもかまわないし、それぞれの弾性率を変えることで、屈曲動作を適切に調整してもかまわない。
次に、図4の(i)は、本発明の実施例9に係る弾性チューブ1cの構造を示す。同図は、網目筒状の弾性シートを弾性チューブ本体11に埋め込んだ構成の断面図である。より具体的に説明すれば、弾性チューブ1cは、弾性チューブ本体11における内周面と外周面との間に弾性シートが配置される構成である。すなわち、図4の(i)に示す弾性チューブ本体11は、非伸縮体4および弾性シートが弾性チューブ本体11と予め一体化された状態で成型されることにより、非伸縮体4および弾性シートを弾性チューブ本体11に固着することができる。
図5の(a)は、本発明の実施例10に係る弾性チューブ1dの構造を示す。同図は、図4の(g)に示す弾性チューブ1cの更に外周に別の弾性チューブ1mを巻いた構成の断面図である。弾性チューブ1dは、弾性チューブ1cの外周にさらに別の弾性チューブ1mがあることにより、屈曲に寄与しないチューブの周囲方向(横方向)の膨張を抑制し、湾曲角度の制御に直接影響する長軸方向(縦方向)の膨張を促し、屈曲を効果的に行うことができるといった特段の効果を生むことができる。また、無駄なチューブの周囲方向の膨張が抑えられるので、伸縮の繰り返しで生じる機械的ストレスによるチューブの劣化も防ぐことができる。
次に、図5の(b)は、本発明の実施例11に係る弾性チューブ1dの構造を示す。同図は、図4の(h)に示す弾性チューブ1cの更に外周に、別の弾性チューブ1mを巻いた構成の断面図である。弾性チューブ1dは、弾性チューブ1cの外周にさらに別の弾性チューブ1mがあることにより、屈曲に寄与しないチューブの周囲方向(横方向)の膨張を抑制し、湾曲角度の制御に直接影響する長軸方向(縦方向)の膨張を促し、屈曲を効果的に行うことができるといった特段の効果を生むことができる。また、無駄なチューブの周囲方向の膨張が抑えられるので、伸縮の繰り返しで生じる機械的ストレスによるチューブの劣化も防ぐことができる。また、弾性チューブ1mと網目状弾性シートの弾性率の収縮特性を適宜設定することにより、段階的な屈曲動作を行うことができる。また、最外周を平坦な表面とすれば、洗浄容易性を高めることができる。
次に、図5の(c)は、本発明の実施例12に係る弾性チューブ1dの構造を示す。同図は、網目筒状の弾性シートを弾性チューブ本体11に埋め込んだ図4の(i)に示す弾性チューブ1cの更に外周に、別の弾性チューブ1mを巻いた構成の断面図である。弾性チューブ1dは、弾性チューブ1cの外周にさらに別の弾性チューブ1mがあることにより、屈曲に寄与しないチューブの周囲方向(横方向)の膨張を抑制し、湾曲角度の制御に直接影響する長軸方向(縦方向)の膨張を促し、屈曲を効果的に行うことができるといった特段の効果を生むことができる。また、無駄なチューブの周囲方向の膨張が抑えられるので、伸縮の繰り返しで生じる機械的ストレスによるチューブの劣化も防ぐことができる。また、弾性チューブ1mと網目状弾性シートの弾性率の収縮特性を適宜設定することにより、段階的な屈曲動作を行うことができる。
次に、図5の(d)は、本発明の実施例13に係る弾性チューブ1dの構造を示す。同図は、図4の(d)に示す弾性チューブ1bの更に外周に、断面を波型構造とした外周チューブを巻き、更にその外周に別の外周チューブを巻いた構成の断面図である。このように、外周チューブの断面を波型構造とし、この波型が広がるまでは張力がほとんどかからないようにすることによって、中空にするのと同等の効果を得、かつ、中空部分の領域を低減して、屈曲装置の外径を低減してもかまわない。
図11の(a)~(c)に示すように、上述した内視鏡部10を、複数の屈曲部31および非屈曲部32が交互に設けられた多関節屈曲部30で構成しても良い。図11の(a)は、複数の屈曲部31が屈曲していないときの多関節屈曲部30の状態を示す。一方、図11の(b)および(c)は、複数の屈曲部31のそれぞれが屈曲しているときの多関節屈曲部30の状態を示す。
図1において、制御装置20について説明する。制御装置20は、弾性チューブ1内の空気(気体)Wの圧力を変更するピストン(気圧可変部)21及びシリンジ22(図7)と、空気Wの圧力を検知する空気圧センサ23と、ピストン21をシリンジ22内で作動させ、弾性チューブ1内の空気圧を可変するピストン駆動部(気圧可変部)24と、術者の音声(指示)を入力するマイクロフォン(指示受付部)25と、マイクロフォン25にて入力された音声信号及び空気圧センサ23の検知信号を入力し、ピストン駆動部24を制御するピストン制御部(気圧可変部)26とを備えている。なお、弾性チューブ1内に封入される気体は、空気に限定されず、医療処置部位を汚染しない気体であればどのようなものでもよい。
図10は、医療処置(手術)状況を示す正面図である(一例)。図10に示すように、マイクロフォン25にて検知された術者105の音声により、ピストン制御部26にてピストン駆動部24を制御し、ピストン21およびシリンジ22を用いて弾性チューブ1内の空気圧を変化させる。なお、ピストン21およびシリンジ22の詳細については、図7にて後述する。
図7は、空気圧を可変制御するピストン21及びシリンジ22の具体的な構造を示し、接続チューブ5に接続されたシリンジ22内にピストン21が摺動可能に挿入されている。ピストン駆動部24は、基台28の取付部29に一端側(図中左側)が固定され、他端側(図中右側)がピストン駆動部24に連結されたネジ部27で、ピストン21は、このネジ部27に螺合されている。ピストン駆動部24にて、ネジ部27が正回転又は逆回転され、これによりピストン21は図中左右方向に移動する。このピストン駆動部24の正回転又は逆回転及びその回転数はピストン制御部26にて制御される。
図8は、本発明実施の形態に係る弾性チューブの湾曲特性を示す図である。図8における横軸は、弾性チューブ本体11内にある空気Wの圧力(P[kPa])であり、縦軸は弾性チューブ本体11の湾曲角度(θ[°])を表す。
また、弾性チューブ1は、自動操作される構成であってもよい。例えば、医療器具として図1に示す内視鏡カメラ2を用いる場合、内視鏡カメラ2によって撮影された画像をカメラモニタ6に表示すると同時に、内視鏡カメラ2によって撮影された画像を、制御装置20において取得および解析する構成(不図示)としてもよい。制御装置20は、解析した情報に応じて、弾性チューブ本体11内に封入された気体の圧力を自動調整する。それゆえ、内視鏡カメラ2の湾曲角度を自動で変化させることができる。なお、制御装置20には、医療処置の進み具合を示す画像データ等が予め格納されているものとする。また、制御装置20は、図8に示すヒステリシス特性を用いて、内視鏡カメラ2の湾曲角度を変化させてもよい。
本発明の態様1に係る弾性チューブ(1)は、細長い中空円筒形を有する弾性チューブ本体(11)と、前記弾性チューブ本体の密封された一方の先端に設けられ、医療器具(内視鏡カメラ2、カテーテル2a、レーザメス2c)を取り付け可能な固定部(12)と、前記弾性チューブ本体の長軸方向に、可撓性を有する非伸縮体(4)を固着可能な固着部(13)とを有し、前記弾性チューブ本体の内部に注入された気体の圧力が制御されることにより、前記非伸縮体の反対側において膨張または収縮することを特徴とする、医療機器(内視鏡装置100)に用いられるものである。
なお、本発明は以下のように表現することも可能である。
1a 弾性チューブ
1b 弾性チューブ
2 内視鏡カメラ
2a カテーテル
2b バルーン
2c レーザメス
3 非膨張チューブ
4 非伸縮体
5 接続チューブ
6 カメラモニタ
7 可撓性スタンド
8 手術台
10 内視鏡部(医療機器部)
10a,10b 医療機器部
11 弾性チューブ本体
12 固定部
13 固着部
14 ケーブル
20 制御装置
21 ピストン(気圧可変部)
22 シリンジ
23 空気圧センサ
24 ピストン駆動部(気圧可変部)
25 マイクロフォン(指示受付部)
26 ピストン制御部(気圧可変部)
27 ネジ部
100 内視鏡装置(医療機器)
Claims (15)
- 細長い中空円筒形を有する弾性チューブ本体と、
前記弾性チューブ本体の密封された一方の先端に設けられ、医療器具を取り付け可能な固定部と、
前記弾性チューブ本体の長軸方向に、可撓性を有する非伸縮体を固着可能な固着部とを有し、
前記弾性チューブ本体の内部に注入された気体の圧力が制御されることにより、前記非伸縮体の反対側において膨張または収縮することを特徴とする、医療機器に用いられる弾性チューブ。 - 前記固着部は、前記弾性チューブ本体よりも伸縮性が低い素材からなる前記非伸縮体を、前記弾性チューブ本体に固着するものであることを特徴とする請求項1に記載の弾性チューブ。
- 前記固着部は、前記医療器具に接続されたケーブルを、前記非伸縮体として前記弾性チューブ本体に固着するものであることを特徴とする請求項1に記載の弾性チューブ。
- 前記固着部は、前記弾性チューブ本体における内周面と外周面との間に配置されることを特徴とする、請求項1から3の何れか1項に記載の弾性チューブ。
- 前記固着部は、前記弾性チューブ本体における中空内部に配置されることを特徴とする、請求項1から3の何れか1項に記載の弾性チューブ。
- 前記弾性チューブ本体は、前記医療器具に接続されたケーブルを、前記弾性チューブ本体における中空内部に配置するものであることを特徴とする請求項1、2または4に記載の弾性チューブ。
- 前記弾性チューブは、周囲方向と比較して長軸方向に伸縮し易い、屈曲方向に対して異なる異方伸縮特性を示すチューブであることを特徴とする請求項1から6の何れか1項に記載の弾性チューブ。
- 前記屈曲方向に対して異なる異方伸縮特性を示す弾性チューブは、網目状の弾性体が固着された構造を備えていることを特徴とする請求項7に記載の弾性チューブ。
- 前記弾性チューブは、内部圧力の大きさに対して段階的な伸縮特性を示すチューブであることを特徴とする請求項1から6の何れか1項に記載の弾性チューブ。
- 前記弾性チューブは、複数の弾性チューブもしくは異方伸縮性弾性体からなる複数の層構造を有していることを特徴とする請求項7から9の何れか1項に記載の弾性チューブ。
- 前記複数の弾性チューブは、弾性率の異なる弾性チューブもしくは弾性率の異なる異方伸縮性弾性体から構成されていることを特徴とする請求項10に記載の弾性チューブ。
- 請求項1に記載の弾性チューブの膨張および収縮を制御する制御装置であって、
前記弾性チューブの膨張または収縮させる指示を受け付ける指示受付部と、
前記指示受付部で受け付けた前記指示に基づいて、前記弾性チューブ本体の中空内部に注入された気体の圧力を可変させる気圧可変部とを備えることを特徴とする制御装置。 - 前記気圧可変部は、前記医療器具が取得した情報に従って自動操作されることを特徴とする請求項12に記載の制御装置。
- 請求項1に記載の弾性チューブと、請求項12に記載の制御装置とを備えた医療機器。
- 前記医療器具として、内視鏡カメラ、カテーテル、レーザメスまたは電気メスを備えた請求項14に記載の医療機器。
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US15/030,928 US20160249900A1 (en) | 2013-10-25 | 2014-09-10 | Elastic tube, control device, and medical equipment |
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US10292572B2 (en) | 2014-04-10 | 2019-05-21 | Sharp Kabushiki Kaisha | Bending device, control device, and medical instrument |
US10492669B2 (en) | 2014-05-30 | 2019-12-03 | Sharp Kabushiki Kaisha | Bending device, control device, and medical instrument |
JP2020512169A (ja) * | 2017-03-24 | 2020-04-23 | ロバート ジェイ.コットーネRobert J. COTTONE | 組織変位のためのシステム及び方法 |
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CN109996490B (zh) | 2016-09-28 | 2023-01-10 | 项目莫里股份有限公司 | 用于机器人导管系统和其它用途的基站、充电站和/或服务器以及改进的铰转装置和系统 |
US10248525B2 (en) * | 2016-10-11 | 2019-04-02 | Bayer Oy | Intelligent medical implant and monitoring system |
EP4289329A1 (en) * | 2021-02-03 | 2023-12-13 | Korea Advanced Institute of Science and Technology | Colon straightening apparatus, colon straightening system comprising same, and method for manufacturing colon straightening apparatus |
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