WO2016021231A1 - 内視鏡 - Google Patents
内視鏡 Download PDFInfo
- Publication number
- WO2016021231A1 WO2016021231A1 PCT/JP2015/060191 JP2015060191W WO2016021231A1 WO 2016021231 A1 WO2016021231 A1 WO 2016021231A1 JP 2015060191 W JP2015060191 W JP 2015060191W WO 2016021231 A1 WO2016021231 A1 WO 2016021231A1
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- WO
- WIPO (PCT)
- Prior art keywords
- space
- distal end
- endoscope
- tip
- hole
- Prior art date
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Classifications
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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
- A61B1/00098—Deflecting means for inserted tools
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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
- A61B1/00078—Insertion part of the endoscope body with stiffening means
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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
- A61B1/00096—Optical elements
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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
- A61B1/012—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 characterised by internal passages or accessories therefor
- A61B1/018—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 characterised by internal passages or accessories therefor for receiving instruments
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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
- A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
- A61B1/05—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances characterised by the image sensor, e.g. camera, being in the distal end portion
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- G—PHYSICS
- G02—OPTICS
- G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
- G02B23/00—Telescopes, e.g. binoculars; Periscopes; Instruments for viewing the inside of hollow bodies; Viewfinders; Optical aiming or sighting devices
- G02B23/24—Instruments or systems for viewing the inside of hollow bodies, e.g. fibrescopes
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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
- A61B1/005—Flexible endoscopes
- A61B1/008—Articulations
Definitions
- the opening of the elevator drive chamber is sealed watertight with a sealing lid, and an electrically insulating plastic cover is covered on the tip body.
- an O-ring is provided on the elevator drive lever to prevent liquid such as body fluid from entering the elevator housing chamber from the outside.
- the observation window and the illumination window are provided in a watertight manner with respect to the tip body. As a result, the liquid is prevented from entering the tip body from the outside through the observation window and the illumination window.
- a sealing member such as an adhesive is applied around the light guide fiber bundle to close the opening at the boundary between the tip body and the curved portion, and the illumination optical system is placed in a sealed space. It is possible to arrange them.
- pressurized air for water leakage detection is not supplied into the sealed space, and the adhesive layer between the illumination lens and the tip body is peeled off or illuminated. It becomes difficult to find a damaged lens.
- the present invention has been made in view of the above circumstances, and an illumination optical system and an imaging optical system provided at a distal end portion having a raising base are disposed without increasing the diameter of an insertion portion including a bending portion. It is an object of the present invention to provide an endoscope that can supply pressurized air to a space that prevents dust and the like in a curved portion from entering the space.
- FIG. 6 The figure explaining the endoscope of the side view type It is the figure which looked at the front-end
- an endoscope 1 is a side-view type endoscope.
- an endoscope 1 includes an insertion portion 2 to be inserted into a subject, an operation portion 3 provided on the proximal end side of the insertion portion 2, and a universal cord 4 extending from the operation portion 3. And is configured.
- the operation unit 3 of the endoscope 1 includes a bending operation device 11, an air / water supply button 12, a suction button 13, a raising base operation lever 51 constituting a raising device 50 described later, and various operation switches 14. Is provided.
- the operation switch 14 is a freeze switch for generating a freeze signal, a release switch for generating a release signal when taking a picture, an observation mode switching switch for instructing an observation mode switching, or the like.
- the operation unit 3 is provided with a treatment instrument insertion port 15 for introducing a treatment instrument (not shown) into the body.
- One end side of the treatment instrument insertion channel 16 is connected to the treatment instrument insertion port 15, and the other end side of the treatment instrument insertion channel 16 is a distal end portion body (described later) that constitutes the distal end portion 5 of the insertion portion 2.
- the treatment instrument insertion channel 16 is a flexible tube body and is disposed in the insertion portion 2 along the longitudinal axis of the insertion portion 2.
- Reference numeral 10 denotes a tube member, which is a resin tube having a flexible longitudinal through hole.
- the tube member 10 is a dual-purpose tube body which will be described later, and is inserted into the insertion portion 2 along the longitudinal axis of the insertion portion 2.
- the proximal end surface of the tube member 10 is provided in the operation unit 3, and an elevator operating wire 52 constituting the elevator device 50 is inserted into the tube member 10.
- a midway portion of the elevator operation wire 52 is disposed in the tube member 10.
- the tip of the elevator operating wire 52 is led out from the tube member 10 and connected to an elevator operating arm (see reference numeral 53 in FIG. 5) that constitutes the elevator apparatus 50.
- the proximal end of the raising base operation wire 52 extends from the proximal end of the tube member 10 and is connected to the raising base operation lever 51 via a link mechanism (not shown).
- reference numeral 6af is a tip bending piece
- reference numeral 6a1 is a first intermediate bending piece, which is a part of a plurality of bending pieces constituting a bending piece set.
- the distal end portion 5 is configured by providing a distal end portion main body 20 and a cover member 30.
- the distal end main body 20 is a hard member, for example, made of metal
- the cover member 30 is a hard member, for example, made of resin.
- the cover member 30 is fixed integrally with the distal end body 20 while maintaining watertightness except for the flat surface portion 5F and the proximal end side of the distal end body 20.
- the elevator stand space 25 is a recess provided in the central portion of the tip body 20 and is a groove having a predetermined depth from the tip surface of the tip body 20 and is opposed to the longitudinal axis 20a. 25a and 25b.
- an elevator 54 constituting the elevator device 50 is rotatably arranged.
- the raising device 50 is mainly configured by the above-described raising base operation lever 51, the raising base operation wire 52, the raising base operation arm 53, and the raising base 54.
- the elevator control lever 51, the elevator operation arm 53, and the elevator 54 are hard members and are made of metal or resin.
- the optical recess 24 is a groove formed along the longitudinal axis 20a.
- the optical recess 24 is provided on the left side of the elevator stand space 25 when the tip body 20 is viewed from the tip surface side.
- the illumination window hole 22 and the observation window hole 23 are formed to communicate with the optical recess 24.
- the arm housing chamber 26 is a recess provided on the right side of the elevator stand space 25 when the tip body 20 is viewed from the tip surface side, and an opening 26m of the arm housing chamber 26 is formed on the right side surface.
- the arm housing chamber 26 is configured by providing an arm recess 27 and a fixture recess 28.
- the shaft hole 27h is a through hole that connects the arm recess 27 and the elevator stand space 25, and the shaft portion 53b of the elevator operating arm 53 is rotatably arranged.
- Reference numeral 60 a is the first opening 60 a of the communication passage 60.
- the communication passage 60 is a through hole having a first opening 60 a in the arm recess 27 and a second opening 60 b in the optical recess 24 as shown in FIG. 10 described later.
- the raising base operation arm 53 has an L shape and is provided with an arm main body 53 a and a shaft portion 53 b. On the end face side of the arm main body 53a, there is provided a wire fixing portion 53c, which is a through hole, to which the tip end portion of the raising base operation wire 52 is fixed.
- the elevator operating wire 52 passes through the through hole 62 formed in the pipe-shaped fixture 61 fixed in the fixture recess 28 and passes through the arm recess 27. Led to.
- the main body 63 of the fixture 61 is integrally fixed in the fixture recess 28 by soldering, bonding, screw fixing, or the like.
- the proximal end portion of the fixture 61 is configured as a tube member connecting portion 64 to which the distal end portion of the tube member 10 is fixed.
- the pipe member connecting portion 64 protrudes from the proximal end surface of the distal end portion main body 20 to the inner space side of the bending portion 6 by a predetermined amount.
- the tube member 10 is integrally fitted to the fixture 61 by an adhesive 65 after being fitted around the tube member connecting portion 64.
- the adhesive 65 is applied to the periphery of the distal end portion of the tube member 10 and the proximal end surface of the distal end portion main body 20.
- the adhesive 65 seals the proximal-side opening of the fixture recess 28 in which the fixture 61 is disposed from the internal space of the bending portion 6.
- the fixing of the tube member 10 and the tube member connecting portion 64 is not limited to an adhesive, and can be performed by binding with a thread-like member such as Tegs.
- the hole shape at the end of the through-hole 62 on the tube member connecting portion 64 side is a taper shape, and the inner diameter on the proximal end opening side is larger and becomes smaller toward the middle. According to this configuration, the tip of the raising base operation wire 52 led out from the tube member 10 is smoothly inserted into the through hole 62, then passes through the through hole 62 and led out to the arm recess 27. .
- the tip of the raising base operation wire 52 is passed through the introduction hole 53e and is disposed in the wire fixing portion 53c.
- the tip of the raising base operation wire 52 is fixed so as not to drop off to the arm main body 53a by, for example, solder applied to the wire fixing portion 53c or brazing.
- the introduction hole 53e has a substantially fan shape as shown in FIG. 6, and is formed so as to gradually expand from the wire fixing portion 53c toward one side surface.
- Reference numeral 66 denotes a dual-purpose tube protection member that is a coil member that protects the tube member 10 and is disposed on the outer peripheral side of the tube member 10.
- the distal end portion of the dual-purpose tube protection member 66 is fixed to the vicinity of the proximal end surface of the distal end portion main body 20 by an adhesive 65. Further, the outer surface of the dual-purpose tube protection member 66 is covered with a tube protection member 67.
- the tube protection member 67 covers the dual-purpose tube protection member 66 at least in the range of the curved portion 6, so that the dual-purpose tube protective member 66 is in contact with other built-in objects and is damaged during the bending operation of the curved portion 6. This is prevented (see FIG. 7).
- the cross-sectional shape of the shaft portion 53b shown in FIG. 5 is a circle and is rotatably disposed in the shaft hole 27h. As shown in FIG. 9, an O-ring 55 is provided on the shaft portion 53b. The O-ring 55 is in close contact with the entire inner circumference of the shaft hole 27h to maintain watertightness.
- the O-ring 55 is disposed in the circumferential groove 55g shown in FIG.
- An end surface side of the shaft portion 53b from the circumferential groove 55g is an elevator base connecting portion 53d.
- On the outer peripheral surface of the raising base connecting portion 53d for example, three flat portions 53f serving as detents are provided at equal intervals.
- Reference numeral 53h is a stop hole, on which the distal end side of the locking pin is disposed.
- the shaft portion 53b projects into the elevator stand space 25 from the first wall surface 25a. Further, the elevator connection portion 53d is disposed in the connection hole 54h of the elevator 54 arranged in the elevator space 25.
- the connecting hole 54h is provided with a contact plane 54f corresponding to the plane portion 53f.
- a locking pin hole (not shown) in which a locking pin is disposed is formed in the vicinity of the connecting hole 54h. The locking pin (not shown) in the connected state is fixed in the locking pin hole and the locking hole.
- the raising base connecting portion 53 d that protrudes toward the raising base space 25 is fixed in the connecting hole 54 h that is a through hole provided in the raising base 54,
- the operation arm 53 and the raising base 54 are integrally formed.
- the distal end portion of the treatment instrument insertion channel 16 through which the treatment instrument or the like is inserted is fixed to the proximal end portion of the channel cap 19 fixed to the distal end portion main body 20.
- the channel cap 19 is fixed in a cap hole 20 h which is a through hole formed at a predetermined position along the longitudinal axis of the tip body 20.
- the opening 20h for the base is provided with an opening on the side of the elevator space 25 in consideration of the arrangement position of the elevator 54 without being connected to the communication passage 60.
- the opening 26m of the arm accommodating chamber 26 is sealed with a cover member 29 and covered with a cover member 30.
- an O-ring 55 provided on the shaft portion 53b is in close contact with the entire inner circumference of the shaft hole 27h to maintain watertightness.
- the proximal-side opening of the fixture recess 28 where the fixture 61 is disposed and the distal end portion of the tube member 10 are sealed with respect to the internal space of the bending portion 6 by the adhesive 65. It has been stopped.
- the proximal end surface of the pipe member 10 is provided in the operation unit 3.
- the arm accommodating chamber 26 of the distal end portion main body 20 is provided in the distal end portion 5 as the first sealed space S1 sealed with respect to the internal space of the bending portion 6.
- an illumination lens 81 that is an illumination window constituting the illumination optical system 8 is fixed to the illumination window hole 22 in a watertight manner.
- an observation lens 91 which is an observation window constituting the observation optical system 9 is fixed to the observation window hole 23 in a watertight manner.
- Reference numeral 17 denotes a nozzle. A fluid such as water or air is ejected from the nozzle 17 toward the illumination lens 81 and the observation lens 91.
- Reference numeral 18 denotes an air / water supply pipeline.
- the illumination optical system 8 mainly includes an illumination lens 81 and a light guide fiber bundle 82.
- the distal end surface of the light guide fiber bundle 82 faces the proximal end surface of the illumination lens 81.
- the proximal end portion of the light guide fiber bundle 82 extends from the opening on the proximal end side of the optical recess 24 and passes through the insertion portion, the operation portion, and the universal cord in advance in the endoscope connector (not shown). It is arranged at a predetermined position.
- the observation optical system 9 mainly includes an observation lens 91, an imaging device 92, and a signal cable 93.
- the imaging device 92 is configured by providing a substrate on which a plurality of optical lenses, an imaging element, and electronic components (not shown) are mounted.
- the observation lens 91 constitutes the tip side of the imaging device 92. Similar to the light guide fiber bundle 82, the base end portion of the signal cable 93 extends from the base end side opening of the optical recess 24 and passes through the insertion portion, the operation portion, the universal cord, and the endoscope connector. Are disposed at predetermined positions.
- Numeral 60b is the second opening of the communication passage 60.
- Reference numeral 5M denotes a tip portion constituting member, which is integrally fixed in the optical recess 24 by, for example, bonding or the like as shown in FIGS.
- the tip component member 5M is provided with an optical system housing 5a and an imaging device support 5b.
- the optical system accommodating portion 5a is provided with a light guide arranging portion 5c where the light guide fiber bundle 82 is arranged and an imaging device accommodating space 5d where the imaging device 92 is arranged. As shown in FIGS. 9 and 10, the light guide fiber bundle 82 is arranged along the bottom surface of the light guide arrangement portion 5 c. The imaging device 92 is disposed in the imaging device accommodation space 5d so as to be separated from the light guide fiber bundle 82.
- the opening on the tip side and the opening on the bottom side of the optical recess 24 provided with the tip portion constituting member 5 ⁇ / b> M are covered and covered with the cover member 30. Further, the opening on the proximal end side of the optical recess 24 is closed by applying the sealing member 100 after the distal end component member 5M is provided.
- the sealing member 100 fills the periphery of the light guide fiber bundle 82 extending from the opening on the proximal end side of the optical recess 24 and the periphery of the signal cable 93, the proximal end surface of the distal end component member 5M, and the inner surface of the cover member 30.
- the optical concave portion 24 of the distal end portion body 20 is provided in the distal end portion 5 as the second sealed space S ⁇ b> 2 sealed with respect to the internal space of the bending portion 6.
- 1st sealed space S1 and 2nd sealed space S2 are connected by the communication channel
- the endoscope configured as described above will be described.
- the operator when performing an inspection in the bile duct, the operator first places the distal end portion 5 of the insertion portion 2 of the endoscope 1 through the duodenum.
- the surgeon inserts the treatment instrument into the treatment instrument insertion channel 16 via the treatment instrument insertion port 15 provided in the operation unit 3 of the endoscope 1.
- the surgeon passes the treatment tool through the channel 16 and the raising base 54 and projects the treatment tool to the outside of the distal end portion 5 by a predetermined amount.
- the surgeon operates the elevator control lever 51.
- the raising base operation wire 52 in the pipe member 10 is moved.
- the arm main body 53a of the elevator operating arm 53 moves from the state shown by the solid line in FIG. 6 to the state shown by the broken line in the first sealed space S1 around the shaft portion 53b. It will be done.
- the elevator 54 that is integrally fixed to the elevator operation arm 53 is similarly rotated in the elevator space 25 to change the direction of the treatment instrument.
- the distal end of the treatment tool is opposed to the bile duct.
- the surgeon inserts the treatment tool into the bile duct and conducts an inspection or the like. After the examination, the surgeon removes the endoscope 1 from the body.
- the endoscope after inspection is cleaned and disinfected.
- water leakage is detected in order to check whether or not there is a hole in the insertion portion 2 or the like. That is, pressurized air is supplied from the endoscope connector (not shown) of the endoscope into the universal cord 4, the operation unit 3, and the insertion unit 2.
- the pressurized air passes through the inside of the tube member 10 from the base end opening 10 and is supplied into the first sealed space S1 provided at the distal end portion 5, and also passes through the communication passage 60. Thus, it is also supplied into the second sealed space S2 provided at the distal end portion 5.
- the first sealed space S1 and the second sealed space S2 sealed with respect to the internal space of the bending portion 6 are provided in the distal end portion 5, and the first sealed space S1 and the second sealed space are provided.
- the space S2 is communicated with the communication passage 60.
- one end of the pipe member 10 is communicated with the first sealed space S1, and the proximal end is disposed in the operation unit.
- the tube member 10 serves as both a guide tube through which the elevator operating wire 52 is inserted and a fluid tube that supplies pressurized air.
- the lubricant of the powder applied to the bending piece set constituting the bending portion 6 is not sealed in the first sealed space without changing the configuration of the raising device 50 without increasing the diameter of the insertion portion 2.
- the problem of entering the S1 and the second sealed space S2 can be solved.
- pressurized air can be supplied into the first sealed space S1 and the second sealed space S2 to more reliably detect water leakage in the insertion portion 2.
- the endoscope 1 described above is a side-view type endoscope.
- the endoscope is not limited to a side-viewing endoscope, and can also be applied to a direct-viewing endoscope in which an elevator is provided in a treatment instrument insertion channel.
- the pipe member 10 of embodiment mentioned above is a resin tube which has flexibility, and has a longitudinal through-hole.
- the tube member 10 is not limited to a resin tube having a longitudinal through hole.
- the tube member 10 may be a resin tube having a plurality of fine through holes that connect the inside of the longitudinal through hole and the outside of the outer peripheral surface.
- the pipe member 10 can be made thin. Furthermore, even when the first space is not completely sealed, the lubricant from the curved pipe portion can be reduced by sufficiently narrowing the communication passage or by making the direction of the passage substantially vertical from the long axis direction. It is possible to make it difficult to enter the second space.
- 11A, 11B, and 11C are formed in the elevator connection portion 53d having the flat surface portion 53f of the elevator operation arm 53, and the elevator connection portion as shown in FIGS. 12A and 12B is formed.
- the cleaning performance may be improved by connecting 53d to the connecting hole 54h of the elevator 54.
- one circumferential groove 53g for dividing the flat portion 53f into two is provided at the center of the flat portion 53f.
- the width dimension of the circumferential groove 53g is appropriately set in consideration of the area of the flat portion 53f.
- two circumferential grooves 53g1 and 53g2 for dividing the plane portion 53f into three are provided.
- the width dimensions of the circumferential grooves 53g1 and 53g2 are, for example, the same dimensions, and are appropriately set in consideration of the area of the flat surface portion 53f.
- a plurality of orthogonal grooves 53h that are orthogonal to the circumferential groove 53g are provided in addition to one circumferential groove 53g that bisects the plane portion 53f.
- the orthogonal grooves 53h are provided between the flat portions 53f and the flat portions 53f, respectively.
- the width dimension of the orthogonal groove 53h is appropriately set in consideration of the area of the flat portion 53f.
- the cleaning liquid or the rinsing liquid when supplied into the raising space 25 as shown in FIGS. 12A and 12B, the liquid flows between the raising base connecting portion 53 d and the connecting hole 54 h of the rising base 54. After entering the gap and passing through the gap, it can flow into the circumferential groove 53g, the first circumferential groove 53g1, the second circumferential groove 53g2, or the orthogonal groove 53h to quickly wash away dirt accumulated in the gap.
- the adjacent bending pieces of this embodiment have the connection part 70 shown to FIG. 13A and FIG. 13B.
- the connecting part 70 includes a first connecting part 71 and a second connecting part 72.
- the first connecting portion 71 is provided, for example, on the proximal end side of the intermediate bending piece, and the second connecting portion 72 is provided, for example, on the proximal end side of the intermediate bending piece.
- the second connecting portion 72 has a pin hole 73.
- the first connecting portion 71 has a pin hole 74 and a restriction hole 75.
- the restriction hole 75 has a first contact surface 75a and a second contact surface 75b.
- One side portion of the rising portion 72a of the second connecting portion 72 is in contact with the first contact surface 75a, and the other side portion of the rising portion 72a of the second connecting portion 72 is in contact with the second contact surface 75b. Touch.
- a connecting pin 76 is disposed in the pin hole 73 of the second connecting portion 72 and the pin hole 74 of the first connecting portion 71, and is fixed by caulking.
- the connecting pin 76 is fixed by caulking so that adjacent intermediate bending pieces are in a freely connected state.
- the rotation range of the first intermediate bending piece 77 and the second intermediate bending piece 78 that are rotatably connected by the connecting pin 76 is such that the side portion of the rising portion 72 a contacts the first contact surface 75 a of the restriction hole 75. It is regulated by contacting or by contacting the second contact surface 75b.
- the base end corner portion 77 ra of the first intermediate bending piece 77 and the second intermediate bending piece 78 is in a non-contact state and is separated by a predetermined distance.
- the distance between the base end corner portion 77ra of the first intermediate bending piece 77 and the front end corner portion 78fa of the second intermediate bending piece 78 is set by appropriately setting the width dimension W and the angle ⁇ of the first connecting portion 71, etc.
- the desired non-contact state can be set.
- the pressurized air is supplied to the space in which the illumination optical system and the imaging optical system provided at the distal end portion having the raising base are disposed without making the insertion portion including the curved portion thick. It is possible to realize an endoscope that prevents dust and the like in the curved portion from entering the space.
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Abstract
Description
内視鏡は、十二指腸経由で膵胆管を造影する内視鏡的逆行性胆道膵管造影、総胆管結石(胆石)の除去を行う内視鏡的乳頭括約筋切開術等の手技に対応している。
処置具挿通用チャンネルは、造影チューブ、バスケットカテーテル、バルーンカテーテル等の処置具が挿通される貫通孔を有するチューブ体である。処置具挿通用チャンネルは、挿入部内に挿入部長手軸に沿って配設されている。処置具挿通用チャンネルの先端は、内視鏡の先端部を構成する先端部本体に接続され、基端は操作部に設けられた処置具挿入口に接続されている。
この内視鏡では、挿入部先端の側面の左右両半部の一方の半部に観察窓を設け、他方の半部に遠隔操作によって前後方向に揺動される処置具起上台を設けている。挿入部先端には、処置具起上台の揺動範囲において上記処置具起上台の両側面に接する内外一対の壁が形成され、遠隔操作される操作ワイヤの先端を外側の壁面の裏側に配置し、外側の壁を貫いて配置された駆動力伝達部材を介して操作ワイヤ先端の運動を上記処置具起上台に伝達する構成になっている。
また、観察窓及び照明窓は、先端部本体に対して水密に設けられている。この結果、外部から観察窓及び照明窓を介して先端部本体内に液体が浸入することが防止されている。
なお、上述した問題は、側視型の内視鏡に限らず、挿入部の先端部内に起上台を有するその他の内視鏡においても同様である。
なお、以下の説明に用いる各図において、各構成要素を図面上で認識可能な程度の大きさとするため、構成要素毎に縮尺を異ならせてあるものもある。また、本発明は、これらの図に記載された構成要素の数量、構成要素の形状、構成要素の大きさの比率、及び各構成要素の相対的な位置関係のみに限定されるものではない。
図1に示すように内視鏡1は、被検体内に挿入される挿入部2と、挿入部2の基端側に設けられた操作部3と、操作部3から延出するユニバーサルコード4と、を備えて構成されている。
符号10は、管部材であって、可撓性を有する長手貫通孔を有する樹脂チューブである。管部材10は、後述する兼用チューブ体であって、挿入部2の長手軸に沿って挿入部2内に挿通配置されている。管部材10の基端面は、操作部3内に設けられ、管部材10内には起上装置50を構成する起上台操作ワイヤ52が挿通される。
起上台操作ワイヤ52の中途部は、管部材10内に配置される。起上台操作ワイヤ52の先端は、管部材10から導出されて、起上装置50を構成する起上台動作アーム(図5の符号53参照)に接続される。起上台操作ワイヤ52の基端は、管部材10の基端から延出されており、不図示のリンク機構等を介して起上台操作レバー51に接続されている。
内視鏡1の先端部5の一側面である例えば上側面には平面部5Fが設けられている。
上側面とは、湾曲部6の上湾曲方向に対応する面を示している。
先端部本体20は、硬質部材であって例えば金属製であり、カバー部材30は硬質部材であって例えば樹脂製である。
カバー部材30は、先端部本体20の平面部5F及び基端部側を除いて、先端部本体20に対して水密を保持して一体に固定される。
起上装置50は、上述した起上台操作レバー51、起上台操作ワイヤ52、起上台動作アーム53及び起上台54によって主に構成されている。起上台操作レバー51、起上台動作アーム53及び起上台54は、硬質部材であって、金属製或いは樹脂製である。
アーム収容室26は、先端部本体20を先端面側から見て起上台用スペース25の右側に設けられた凹部であって、右側側面にはアーム収容室26の開口26mが形成されている。
アーム収容室26は、アーム用凹部27及び固定具用凹部28を設けて構成されている。
なお、封止する方法として他に、本体部63と固定具用凹部28との隙間を接着剤や封止剤等で埋めるという方法もある。この場合、管部材10と管部材連結部64との固定については、接着剤に限らず、テグス等の糸状部材で縛って行なうことも可能である。
更に兼用チューブ保護部材66の外表面は、チューブ保護部材67により覆われている。このチューブ保護部材67は、少なくとも湾曲部6の範囲において兼用チューブ保護部材66をカバーすることで、湾曲部6の湾曲動作時に兼用チューブ保護部材66が他の内蔵物と接触して破損することを防止している(図7参照)。
この結果、先端部本体20の光学用凹部24が、湾曲部6の内部空間に対して封止された第2の密閉空間S2として先端部5に設けられる。
例えば、胆管内の検査を行う際、術者は、まず、内視鏡1の挿入部2の先端部5を十二指腸内に挿通配置する。次に、術者は、内視鏡1の操作部3に設けられた処置具挿入口15を介して処置具を処置具挿通用チャンネル16内に挿通する。術者は、処置具を該チャンネル16内及び起上台54上を通過させて、予め定めた量、先端部5の外部に突出させる。
検査終了後、術者は、内視鏡1を体内から抜去する。
この構成によれば、管部材10が、起上台操作ワイヤ52が挿通されるガイドチューブと加圧空気を供給する流体チューブとを兼用している。この結果、挿入部2を太径にすることなく、起上装置50の構成を変化させることなく、湾曲部6を構成する湾曲駒組に塗布された粉末の潤滑剤等が第1の密閉空間S1及び第2の密閉空間S2に侵入する不具合を解消することができる。加えて、漏水検知の際に、加圧空気を第1の密閉空間S1内及び第2の密閉空間S2内に供給して、挿入部2内の漏水検知をより確実に行うことができる。
さらに、樹脂チューブだけが設けられていない場合、あるいは、樹脂チューブと保護チューブとが設けられていない場合、さらには、保護チューブだけが設けられていない構成でも良い。この場合、コイルの隙間から潤滑剤が入る可能性が予想される。しかし、コイルの隙間は充分に狭いため、潤滑剤の侵入は充分に防止することができる。このような構成を採用することで、管部材10を細くすることができる。
さらにまた、第1の空間が完全に封止されていない場合でも、連絡通路を充分に狭くするまたは通路の向きを長軸方向から略垂直にすることで、湾曲管部からの潤滑剤が第2の空間に侵入しづらくすることが可能である。
なお、第1中間湾曲駒77の基端角部77raと第2中間湾曲駒78の先端角部78faとの距離離間は、第1連結部71の幅寸法W及び角度θを適宜設定すること等によって所望する非当接状態に設定することが可能である。
Claims (7)
- 操作部と、
前記操作部から延出され、先端側に設けられる先端部及び該先端部に連設する湾曲部を備えた挿入部と、
前記先端部に設けられた第1の空間と、
前記先端部に設けられ、前記湾曲部内空間に対して封止された撮像ユニット及び照明光学系が配設される第2の空間と、
前記先端部に設けられ、前記第1の空間と前記第2の空間とを連絡する連絡通路と、
一端部が前記第1の空間に連結され、他端部が前記操作部内に設けられる細長で長手方向貫通孔を有する管部材と、
を具備することを特徴とする内視鏡。 - 前記第1の空間は、前記湾曲部内の空間に対して封止されていることを特徴とする請求項1に記載の内視鏡。
- 前記第1の空間は、前記先端部に設けられる起上装置を構成する起上台を揺動させる起上台動作アームが配設されるアーム収容室であることを特徴とする請求項1に記載の内視鏡。
- 前記管部材の長手方向貫通孔は、前記起上台動作アームに先端が接続される前記起上装置を構成する起上台操作ワイヤが挿通配置されるワイヤ挿通路及び加圧空気を該第1の空間及び前記連絡通路を介して前記第2の空間に供給するための供給路を兼用することを特徴とする請求項3に記載の内視鏡。
- 前記管部材は、コイルバネのみによって形成されていることを特徴とする請求項1に記載の内視鏡。
- 前記連絡通路の空間体積が、前記第1の空間及び第2の空間の体積よりも小さく設定されていることを特徴とする請求項1に記載の内視鏡。
- 前記連絡通路は、前記挿入部の長軸方向に対し略垂直に形成されていることを特徴とする請求項1に記載の内視鏡。
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EP15830618.3A EP3097843A4 (en) | 2014-08-05 | 2015-03-31 | Endoscope |
CN201580011273.9A CN106061359B (zh) | 2014-08-05 | 2015-03-31 | 内窥镜 |
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