WO2017029832A1 - 医療用シース及び医療機器 - Google Patents
医療用シース及び医療機器 Download PDFInfo
- Publication number
- WO2017029832A1 WO2017029832A1 PCT/JP2016/059139 JP2016059139W WO2017029832A1 WO 2017029832 A1 WO2017029832 A1 WO 2017029832A1 JP 2016059139 W JP2016059139 W JP 2016059139W WO 2017029832 A1 WO2017029832 A1 WO 2017029832A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- sheath
- medical
- illumination light
- insertion portion
- trocar
- Prior art date
Links
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/012—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
-
- 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
- A61B1/00002—Operational features of endoscopes
- A61B1/00004—Operational features of endoscopes characterised by electronic signal processing
- A61B1/00006—Operational features of endoscopes characterised by electronic signal processing of control signals
-
- 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
- A61B1/00002—Operational features of endoscopes
- A61B1/00043—Operational features of endoscopes provided with output arrangements
- A61B1/00045—Display arrangement
-
- 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
- A61B1/00075—Insertion part of the endoscope body with externally roughened shaft
-
- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00147—Holding or positioning arrangements
- A61B1/00154—Holding or positioning arrangements using guiding arrangements for insertion
-
- 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
- A61B1/00163—Optical arrangements
- A61B1/00165—Optical arrangements with light-conductive means, e.g. fibre optics
-
- 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
- A61B1/06—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 illuminating arrangements
- A61B1/0607—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 illuminating arrangements for annular illumination
-
- 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
- A61B1/06—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 illuminating arrangements
- A61B1/0661—Endoscope light sources
-
- 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
- A61B1/06—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 illuminating arrangements
- A61B1/07—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 illuminating arrangements using light-conductive means, e.g. optical fibres
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/30—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
-
- 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
- A61B1/00002—Operational features of endoscopes
- A61B1/00004—Operational features of endoscopes characterised by electronic signal processing
- A61B1/00009—Operational features of endoscopes characterised by electronic signal processing of image signals during a use of endoscope
Definitions
- the present invention relates to a medical sheath and a medical device, and particularly to a medical sheath and a medical device used together with a medical device inserted into a body cavity.
- an optical fiber for guiding light emitted to the test site and / or light emitted from the test site
- a medical device such as a treatment instrument inserted into the body cavity is used in combination.
- Japanese Patent Application Laid-Open No. 05-337073 discloses a trocar having a built-in fiber guide for guiding light for guiding laser light emitted from a laser light source device, and the trocar through the trocar.
- a grasping forceps to be inserted into the body cavity, the laser light emitted from the trocar through the fiber probe for guide light, and the distal end portion of the grasping forceps inserted into the insertion path of the trocar A technique is disclosed that is used as light for guiding into the field of view.
- the force generated in response to the operation of the medical device by the operator is applied to the optical fiber (breaking etc. It is desirable not to act as a cause of mechanical damage.
- the guide light fiber probe is provided at a position different from the insertion path through which the grasping forceps are inserted, thereby operating the grasping forceps. Accordingly, the force generated according to the above is prevented from acting as much as possible as a factor of mechanical damage of the guide light fiber probe.
- the present invention has been made in view of the above-described circumstances, and increases the degree of freedom in the configuration when performing treatment of a site to be examined in a body cavity by using an optical fiber and a medical device in combination. It aims at providing the medical sheath and medical device which can prevent generation
- the medical sheath of one embodiment of the present invention treats a test site existing in the body cavity of the subject using a medical device having an insertion portion that can be inserted into the body cavity of the subject via a trocar.
- a sheath body formed in a shape that can be inserted into and removed from an insertion hole through which the insertion portion is inserted in the trocar, and the insertion portion is provided with the insertion portion.
- one or more optical fibers for guiding the return light emitted from the region.
- a medical device of one embodiment of the present invention includes a medical device having an insertion portion that can be inserted into a body cavity of a subject via a trocar, and a test that exists in the body cavity of the subject using the medical device.
- a sheath body formed in a shape that can be inserted into and removed from the insertion hole through which the insertion portion is inserted in the trocar and used in the treatment of the site, and the insertion portion can be inserted and removed.
- an optical transmission unit for guiding at least one of the return lights to be emitted.
- Sectional drawing for demonstrating the structure of the medical sheath which concerns on the modification of an Example Sectional drawing for demonstrating the structure of the medical sheath which concerns on the modification of an Example.
- 1 to 9 relate to an embodiment and a modification of the present invention.
- the medical system 101 includes a medical device 1, a medical sheath 2, a power supply device 3, a main body device 4, and a display device 5.
- FIG. 1 is a diagram illustrating a configuration of a main part of a medical system including a medical sheath according to an embodiment.
- the medical device 1 is inserted into a body cavity of a subject, for example, and a test site such as a living tissue existing in the body cavity of the subject with energy corresponding to the power supplied from the power supply device 3 It is comprised as a treatment tool which can be applied to and perform treatment.
- the medical device 1 is configured by, for example, a bipolar electric knife or a high-frequency treatment instrument.
- the medical device 1 includes an insertion unit 11 and an operation unit 12 as illustrated in FIG. 1, for example.
- the insertion portion 11 is formed to have an external shape such as an elongated cylindrical shape that can be inserted into the body cavity of the subject via a trocar placed on the body wall of the subject.
- the insertion portion 11 is configured by providing a treatment portion 11 a for applying energy according to the power supplied from the power supply device 3 on the distal end side.
- the insertion part 11 is connected to the operation part 12 via the connection connector CC provided in the base end side.
- connection connector CC of the present embodiment has a structure for connecting the insertion portion 11 to the operation portion 12 in an infinitely rotatable state. That is, the insertion portion 11 of the present embodiment is configured to be able to rotate infinitely with the longitudinal direction as the rotation axis by being connected to the operation portion 12 via the connection connector CC.
- the treatment unit 11 a includes a pair of jaws Ja that are opened and closed according to the operation of the operation unit 12, and supplies energy to a living tissue or the like grasped by the pair of jaws Ja. It is comprised so that it can apply.
- the operation unit 12 is connected to the insertion unit 11 via the connection connector CC.
- the operation unit 12 includes a handle 12a that can perform an operation related to opening and closing of the pair of jaws Ja of the treatment unit 11a.
- the handle portion 12 a is provided with a switch SW that can perform an operation for turning on or off the power supply from the power supply device 3.
- the medical sheath 2 is formed in an external shape that can be inserted into and removed from an insertion hole, which is a hole through which the insertion portion 11 of the trocar placed on the body wall of the subject is inserted, such as an elongated cylindrical shape.
- the sheath main body 20 is provided.
- the medical sheath 2 has a cross-sectional shape exemplified in FIG. 2 in a cross section perpendicular to the longitudinal direction of the sheath body 20.
- the sheath body 20 of the medical sheath 2 is provided with a treatment instrument channel 21 and an optical fiber 22 as shown in FIG.
- FIG. 2 is a cross-sectional view for explaining the configuration of the medical sheath according to the embodiment.
- the sheath body 20 is formed of a material having a low thermal conductivity capable of protecting the optical fiber 22 from heat generated when energy is applied in the treatment portion 11a, such as silicone or fluororesin.
- an insertion portion 11 inserted from the proximal end side can be inserted and disposed in the sheath body 20, and the treatment portion 11a is protruded from the distal end side.
- a treatment instrument channel 21 is formed.
- illumination light supplied from the main body device 4 and return light generated in response to irradiation of the illumination light are guided into the sheath body 20, for example.
- One optical fiber 22 for light emission is inserted and arranged.
- the treatment instrument channel 21 is a conduit formed so as to have a shape in which the insertion portion 11 can be inserted and removed, and is provided along the longitudinal direction of the sheath body 20.
- the treatment instrument channel 21 is formed to have an inner diameter substantially the same as the outer diameter of the cylindrical insertion portion 11, for example, and has a central axis at a position shifted from the central axis of the sheath body 20. It is formed as follows. Moreover, the process for improving the operativity of the insertion part 11 penetrated by the treatment tool channel 21 like the coating by a fluororesin etc. is given to the internal peripheral surface of the treatment tool channel 21, for example.
- the outer peripheral surface of the insertion portion 11 and the inner peripheral surface of the treatment instrument channel 21 are The gap between them can be eliminated. Further, according to the configuration of the treatment instrument channel 21 as described above, the insertion portion 11 inserted through the treatment instrument channel 21 can be smoothly advanced and retracted and rotated.
- the optical fiber 22 is disposed so as not to generate a gap with the sheath body 20 and is provided along the longitudinal direction of the sheath body 20.
- the proximal end portion of the optical fiber 22 is provided so as to extend from the proximal end side of the sheath body 20 and is configured to be detachably connected to the body device 4. Further, the distal end portion of the optical fiber 22 is disposed on the distal end side of the sheath body 20. Further, in the vicinity of the end face at the tip of the optical fiber 22, the illumination light emitted through the end face is condensed and the return light generated in response to the illumination light is condensed to the end face. A condensing lens (not shown) for incidence is provided.
- the power supply device 3 includes, for example, a high-frequency power supply and the like.
- the switch SW of the handle portion 12a When the switch SW of the handle portion 12a is turned on, the power supply device 3 supplies power to the medical device 1 and the switch SW of the handle portion 12a is turned off. The power supply to the medical device 1 is stopped.
- the main unit 4 includes a laser light source 41, a photodetector 42, a signal processing circuit 43, and a control circuit 44.
- the laser light source 41 includes, for example, a laser diode, and generates laser light as illumination light that irradiates a test site to be treated by the medical device 1, and light that is connected to the main body device 4. It is configured to supply to the fiber 22.
- the photodetector 42 includes, for example, an avalanche photodiode and the like, detects return light emitted through the optical fiber 22 connected to the main body device 4, and detects light according to the intensity of the detected return light. A signal is generated and output.
- the signal processing circuit 43 performs predetermined signal processing on the light detection signal output from the light detector 42 to generate an image that visualizes the state of the test site treated by the medical device 1. And output.
- control circuit 44 adjusts the light amount of the laser light emitted from the laser light source 41 in accordance with the signal level of the light detection signal output from the light detector 42 as control related to the operation of each part of the main body device 4. Etc. are configured.
- the display device 5 includes, for example, a liquid crystal display and is configured to display an image output from the main device 4.
- FIG. 3 is a diagram illustrating an example of a state in which the medical sheath according to the embodiment is inserted from the proximal end side of the insertion hole of the trocar TR.
- the user places the medical sheath 2 through the trocar TR in a state where the insertion portion 11 of the medical device 1 is inserted from the proximal end side of the treatment instrument channel 21 of the medical sheath 2.
- the switch SW is turned on with the treatment section 11a protruding from the distal end side of the treatment instrument channel 21, thereby existing in the abdominal cavity of the subject. Treat the test site.
- the sheath body 20 is held by the rubber valve GV provided on the proximal end side of the insertion hole of the trocar TR, and the operability of the insertion portion 11 inserted into the treatment instrument channel 21 is maintained.
- the frictional force acting on the contact surface between the sheath body 20 and the rubber valve GV causes the contact between the insertion portion 11 and the treatment instrument channel 21. It becomes relatively larger than the frictional force acting on the surface.
- the longitudinal direction is rotated during the treatment of the test site in the abdominal cavity of the subject while the insertion portion 11 is inserted into the treatment instrument channel 21. Even if an operation for rotating the insertion portion 11 as a shaft is performed, the rotation of the sheath body 20 that can occur following the rotation of the insertion portion 11 can be suppressed, so that mechanical damage in the optical fiber 22 can be prevented. Occurrence can be prevented.
- the optical fiber 22 and the medical device 1 are used together by attaching the rubber valve GV for preventing gas leakage to the desired trocar TR of the user and inserting the medical sheath 2 therethrough.
- a treatment can be performed on the test site in the body cavity. That is, according to the present embodiment, the occurrence of mechanical damage in the optical fiber while increasing the degree of freedom of the configuration when performing the treatment on the test site in the body cavity by using the optical fiber and the medical device in combination. Can be prevented.
- the medical sheath 2 of the present embodiment may be configured, for example, by providing a rubber valve for preventing gas leakage having the same function as the rubber valve GV on the proximal end side of the treatment instrument channel 21.
- the optical fiber 22 is not limited to the configuration capable of guiding both the illumination light and the return light, and the optical fiber 22 only receives either the illumination light or the return light. You may have the structure which can guide light. That is, the optical fiber 22 of the present embodiment has a configuration for guiding at least one of the illumination light supplied from the main body device 4 and the return light generated in response to the illumination light. It only has to have.
- the processing (coating or the like) for improving the operability of the insertion portion 11 inserted through the treatment instrument channel 21 may not be performed on the inner peripheral surface of the treatment instrument channel 21.
- the optical fiber 22 is divided into two parts, a part extending from the proximal end side of the sheath body 20 and a part built in the sheath body 20.
- the two parts may be detachable from each other.
- the medical sheath 2 of the present embodiment may be configured as a medical sheath 2A including a sheath body 20A having an outer shape as shown in FIG.
- a specific description regarding the portion to which the above-described configuration can be applied will be omitted as appropriate.
- FIG. 4 is a diagram for explaining a configuration of a medical sheath according to a modification of the embodiment.
- the sheath body 20A is provided with a rotation suppressing structure on the outer peripheral surface capable of suppressing rotation that can occur following the rotation of the insertion portion 11 inserted through the treatment instrument channel 21 in a state where the sheath body 20A is inserted through the trocar TR.
- a rotation suppressing structure on the outer peripheral surface capable of suppressing rotation that can occur following the rotation of the insertion portion 11 inserted through the treatment instrument channel 21 in a state where the sheath body 20A is inserted through the trocar TR.
- a rotation suppressing structure on the outer peripheral surface capable of suppressing rotation that can occur following the rotation of the insertion portion 11 inserted through the treatment instrument channel 21 in a state where the sheath body 20A is inserted through the trocar TR.
- a plurality of V-shaped grooves VM formed on the outer peripheral surface of the sheath body 20A as the above-described rotation suppression structure, for example, so as to extend in a direction parallel to the longitudinal direction of the sheath body 20A.
- the groove formed on the outer peripheral surface of the sheath body 20A may have a shape other than the V-shape.
- channel formed in the outer peripheral surface of 20 A of sheath main bodies may be formed over the full length of a longitudinal direction, or may be formed only in the part which can contact with the rubber valve GV of trocar TR.
- the medical sheath 2 of the present embodiment is not limited to the one having the cross-sectional shape illustrated in FIG. 2, for example, a cylindrical medical having the cross-sectional shape shown in FIG. 5.
- the sheath 2B may be configured.
- FIG. 5 is a cross-sectional view for explaining a configuration of a medical sheath according to a modified example of the embodiment.
- the medical sheath 2 ⁇ / b> B includes a plurality of optical fibers 22 ⁇ / b> A for guiding illumination light supplied from the main body device 4 instead of the optical fiber 22 in the medical sheath 2, and A plurality of optical fibers 22B for guiding return light generated in response to illumination light illumination are provided on the sheath body 20 respectively.
- the plurality of optical fibers 22 ⁇ / b> A and 22 ⁇ / b> B are arranged in a substantially fan shape and alternately arranged in the vicinity of the treatment instrument channel 21.
- the base end portions of the plurality of optical fibers 22A and 22B have the same configuration as that of the optical fiber 22, that is, are provided to extend from the base end side of the sheath body 20, and are attached to and detached from the main body device 4. It is configured to be connected as possible. Further, the distal end portions of the plurality of optical fibers 22 ⁇ / b> A and 22 ⁇ / b> B have the same configuration as the optical fiber 22, i.e., are disposed on the distal end side of the sheath body 20. In addition, a condensing lens (not shown) for condensing illumination light emitted through each end face is provided in the vicinity of each end face at the tip of the plurality of optical fibers 22A.
- a condensing lens (not shown) for condensing return light generated in response to irradiation of illumination light and making it incident on each end face is provided in the vicinity of each end face at the tip of the plurality of optical fibers 22B. Is provided.
- the medical sheath 2B having the above-described configuration for example, even when the jaw Ja in the open state can be a factor that blocks the optical path, at least one of the plurality of optical fibers 22A. It is possible to irradiate illumination light to the test site from one side, and it is possible to receive return light emitted from the test site in at least one of the plurality of optical fibers 22B. In addition, according to the medical sheath 2B having the configuration as described above, it is possible to irradiate the test site with a larger amount of illumination light than the medical sheath 2 and to emit from the test site. The received light sensitivity of the returned light can be improved as compared with the medical sheath 2. Moreover, according to the medical sheath 2B having the configuration as described above, the outer diameter can be made thinner than the medical sheath 2C described later.
- the medical system 101 includes the medical sheath 2B, and the illumination light emitted from the laser light source 41 is substantially the same through the plurality of optical fibers 22A.
- the illumination light is not limited to be supplied to the plurality of optical fibers 22A at the same time.
- the optical fiber 22A to which the illumination light is supplied is 1 Switching control for sequentially switching one by one may be performed.
- control circuit 44 is provided with an optical switch such as a MEMS optical switch (not shown) on the optical path from the laser light source 41 to each end face at the base end portion of the plurality of optical fibers 22A.
- optical switch such as a MEMS optical switch (not shown) on the optical path from the laser light source 41 to each end face at the base end portion of the plurality of optical fibers 22A.
- the above-described switching control may be performed so as to sequentially switch the end face of one optical fiber 22A, which is an emission destination of light that has passed through the optical switch, at predetermined intervals.
- the predetermined period may be set to a time longer than the sampling time when FFT (Fast Fourier Transform) is performed as signal processing of the signal processing circuit 43, for example.
- FFT Fast Fourier Transform
- the illumination light emitted from the laser light source 41 can be intensively supplied to the single optical fiber 22A.
- the irradiation density of the illumination light applied to the test site can be increased as much as possible, and as a result, the amount of received light when receiving the return light emitted from the test site with the plurality of optical fibers 22B is maximized. can do.
- the medical sheath 2 of the present embodiment is not limited to the one having the cross-sectional shape illustrated in FIG. 2, for example, a cylindrical medical having the cross-sectional shape shown in FIG. 6. It may be configured as a sheath 2C for use.
- FIG. 6 is a cross-sectional view for explaining a configuration of a medical sheath according to a modification of the embodiment.
- the treatment instrument channel 21 of the medical sheath 2C is formed to have a central axis at the same position as the central axis of the cylindrical sheath body 20, for example, as shown in FIG.
- the medical sheath 2 ⁇ / b> C includes a plurality of optical fibers 22 ⁇ / b> C for guiding illumination light supplied from the main body device 4 instead of the optical fiber 22 in the medical sheath 2.
- a plurality of optical fibers 22D for guiding return light generated in response to the illumination light is provided on the sheath body 20, respectively.
- the plurality of optical fibers 22 ⁇ / b> C and 22 ⁇ / b> D are arranged around the treatment instrument channel 21 in a state of being alternately arranged at substantially equal intervals.
- the base end portions of the plurality of optical fibers 22C and 22D have the same configuration as that of the optical fiber 22, that is, are provided to extend from the base end side of the sheath body 20, and are attached to and detached from the main body device 4. It is configured to be connected as possible. Further, the distal end portions of the plurality of optical fibers 22C and 22D have the same configuration as the optical fiber 22, that is, are disposed on the distal end side of the sheath body 20.
- a condensing lens (not shown) for condensing illumination light emitted through each end face is provided in the vicinity of each end face at the tip of the plurality of optical fibers 22C.
- a condensing lens (not shown) for condensing return light generated in response to illumination light irradiation and making it incident on each end face is provided in the vicinity of each end face at the tip of the plurality of optical fibers 22D. Is provided.
- the medical sheath 2C having the above-described configuration for example, even when the jaw Ja in the open state can be a factor blocking the optical path, at least one of the plurality of optical fibers 22C. Illumination light can be irradiated from one to the test site, and return light emitted from the test site can be received by at least one of the plurality of optical fibers 22D.
- illumination light having a larger amount of light than the medical sheath 2 can be irradiated to the test site and emitted from the test site. The received light sensitivity of the returned light can be improved as compared with the medical sheath 2.
- the medical sheath 2 of the present embodiment is not limited to the one having the cross-sectional shape illustrated in FIG. 2, for example, a cylindrical medical having the cross-sectional shape shown in FIG. 7. It may be configured as a sheath 2D for use.
- FIG. 7 is a cross-sectional view for explaining a configuration of a medical sheath according to a modification of the embodiment.
- the medical sheath 2 ⁇ / b> D includes one optical fiber 22 ⁇ / b> E for guiding illumination light supplied from the main body device 4 instead of the optical fiber 22 in the medical sheath 2, and the illumination light.
- Each optical fiber 22F for guiding the return light generated in response to the irradiation is provided on the sheath body 20 respectively.
- the proximal ends of the optical fibers 22E and 22F have the same configuration as that of the optical fiber 22, that is, extend from the proximal end side of the sheath body 20 and are detachable from the body device 4. Configured to be connected. Further, the distal end portions of the optical fibers 22E and 22F have the same configuration as that of the optical fiber 22, that is, are disposed on the distal end side of the sheath body 20.
- a condensing lens (not shown) for condensing illumination light emitted through the end face is provided in the vicinity of the end face at the tip of the optical fiber 22E. In addition, a condensing lens (not shown) is provided in the vicinity of the end face at the distal end portion of the optical fiber 22F to collect the return light generated in response to illumination light irradiation and enter the end face. .
- a predetermined warning sound may be emitted from a speaker (not shown) provided in the main unit 4 according to the control of the control circuit 44 related to the above-described notification.
- the light emitting elements (not shown) may blink in a predetermined pattern, or a predetermined icon or the like may be displayed on the display device 5.
- the medical sheath 2 of the present embodiment is not limited to the one having the cross-sectional shape illustrated in FIG. 2, and for example, a cylindrical medical having the cross-sectional shape shown in FIG. 8. It may be configured as a sheath 2E for use.
- FIG. 8 is a cross-sectional view for explaining a configuration of a medical sheath according to a modification of the embodiment.
- the medical sheath 2 ⁇ / b> E has two optical fibers 22 ⁇ / b> G for guiding illumination light supplied from the main body device 4 in the sheath main body 20 instead of the optical fiber 22 in the medical sheath 2. It is provided and configured.
- the return light generated in response to illumination light irradiation is guided to the portion other than the treatment instrument channel 21 and the optical fiber 22G inside the sheath body 20 corresponding to the portion shown by the dot pattern in FIG.
- An optical fiber bundle 23A including a plurality of optical fibers for filling is filled without any gaps.
- the light receiving sensitivity of the return light generated in response to the illumination light irradiation can be improved as compared with the medical sheath 2.
- the medical sheath 2 of the present embodiment is not limited to the one having the cross-sectional shape illustrated in FIG. 2, for example, a cylindrical medical having the cross-sectional shape shown in FIG. 9. It may be configured as a sheath 2F for use.
- FIG. 9 is a cross-sectional view for explaining a configuration of a medical sheath according to a modification of the embodiment.
- the treatment instrument channel 21 of the medical sheath 2F is formed to have a central axis at the same position as the central axis of the cylindrical sheath body 20, for example, as shown in FIG.
- the medical sheath 2 ⁇ / b> F includes two optical fibers 22 ⁇ / b> H for guiding illumination light supplied from the main body device 4 instead of the optical fiber 22 in the medical sheath 2.
- the sheath body 20 is provided.
- the return light generated in response to illumination light irradiation is guided to a portion other than the treatment instrument channel 21 and the optical fiber 22H inside the sheath body 20, which corresponds to the portion indicated by the dot pattern in FIG.
- the optical fiber bundle 23 ⁇ / b> B including a plurality of optical fibers is filled without gaps.
- the light receiving sensitivity of the return light generated in response to the irradiation of the illumination light can be improved as compared with the medical sheath 2.
- both the illumination light and the return light can be guided and the heat generated by the treatment portion 11a can be prevented.
- the sheath body 20 may be formed by using a transparent member having resistance, so that the medical sheath itself may serve as a light guide path.
- the optical fiber 22 is inserted and arranged in a portion that matches or substantially matches the central axis in the longitudinal direction of the insertion portion 11. It may be.
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Physics & Mathematics (AREA)
- Optics & Photonics (AREA)
- Biomedical Technology (AREA)
- Public Health (AREA)
- Pathology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Veterinary Medicine (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Radiology & Medical Imaging (AREA)
- Biophysics (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Signal Processing (AREA)
- Instruments For Viewing The Inside Of Hollow Bodies (AREA)
- Radiation-Therapy Devices (AREA)
Abstract
Description
Claims (6)
- トラカールを介して被検体の体腔内に挿入可能な挿入部を有する医療用デバイスを用いて前記被検体の体腔内に存在する被検部位の処置を行う際に併用される医療用シースであって、
前記トラカールにおいて前記挿入部が挿通される挿通孔に対して挿抜可能な形状に形成されたシース本体と、
前記シース本体に設けられ、前記挿入部を挿抜可能な形状を具備するように形成された管路であるチャンネルと、
前記シース本体に設けられ、前記被検部位に照射される照明光、及び、前記照明光の照射に応じて前記被検部位から発せられる戻り光のうちの少なくとも一方の光を導光するための光伝送部と、
を有することを特徴とする医療用シース。 - 前記シース本体は、前記トラカールに挿通されている状態において、前記チャンネルに挿通された前記挿入部の回転に追随して生じ得る回転を抑制することが可能な回転抑制構造を外周面に設けて構成されている
ことを特徴とする請求項1に記載の医療用シース。 - 前記回転抑制構造は、前記シース本体の長手方向に対して平行な方向に伸びるように形成された複数の溝である
ことを特徴とする請求項2に記載の医療用シース。 - 前記チャンネルは、円筒形状の前記挿入部の外径と略同一の内径を具備して形成されている
ことを特徴とする請求項1に記載の医療用シース。 - トラカールを介して被検体の体腔内に挿入可能な挿入部を有する医療用デバイスと、
前記医療用デバイスを用いて前記被検体の体腔内に存在する被検部位の処置を行う際に併用され、前記トラカールにおいて前記挿入部が挿通される挿通孔に対して挿抜可能な形状に形成されたシース本体と、
前記シース本体に設けられ、前記挿入部を挿抜可能な形状を具備するように形成された管路であるチャンネルと、
前記シース本体に設けられ、前記被検部位に照射される照明光、及び、前記照明光の照射に応じて前記被検部位から発せられる戻り光のうちの少なくとも一方の光を導光するための光伝送部と、
を有することを特徴とする医療機器。 - 光源部から発せられた前記照明光を導光するための複数の光ファイバが前記光伝送部に設けられている場合において、前記光源部から発せられた前記照明光の供給先となる光ファイバを1つずつ順次切り替えるための切替制御を行う制御部をさらに有する
ことを特徴とする請求項5に記載の医療機器。
Priority Applications (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP16836824.9A EP3184025A4 (en) | 2015-08-20 | 2016-03-23 | Medical sheath and medical device |
JP2016546113A JP6043036B1 (ja) | 2015-08-20 | 2016-03-23 | 医療用シース及び医療機器 |
CN201680002869.7A CN106714653B (zh) | 2015-08-20 | 2016-03-23 | 医疗用护套和医疗设备 |
US15/466,173 US20170188800A1 (en) | 2015-08-20 | 2017-03-22 | Medical sheath and medical appliance |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP2015-162859 | 2015-08-20 | ||
JP2015162859 | 2015-08-20 |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US15/466,173 Continuation US20170188800A1 (en) | 2015-08-20 | 2017-03-22 | Medical sheath and medical appliance |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2017029832A1 true WO2017029832A1 (ja) | 2017-02-23 |
Family
ID=58051699
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/JP2016/059139 WO2017029832A1 (ja) | 2015-08-20 | 2016-03-23 | 医療用シース及び医療機器 |
Country Status (4)
Country | Link |
---|---|
US (1) | US20170188800A1 (ja) |
EP (1) | EP3184025A4 (ja) |
CN (1) | CN106714653B (ja) |
WO (1) | WO2017029832A1 (ja) |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN110446509A (zh) * | 2016-07-25 | 2019-11-12 | 日机装株式会社 | 光导入装置以及杀菌系统 |
Families Citing this family (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP3934559A4 (en) * | 2019-03-08 | 2022-12-07 | Covidien LP | ROBOTIC SURGICAL PROCESSES |
Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JPH05337073A (ja) | 1992-06-04 | 1993-12-21 | Olympus Optical Co Ltd | 医療器具 |
JPH09135841A (ja) * | 1995-11-14 | 1997-05-27 | Olympus Optical Co Ltd | 気腹針 |
JP2011514202A (ja) * | 2008-03-03 | 2011-05-06 | アプライド メディカル リソーシーズ コーポレイション | バルーントロカールの新固定方式 |
JP2012505694A (ja) * | 2008-10-17 | 2012-03-08 | コーニンクレッカ フィリップス エレクトロニクス エヌ ヴィ | 連動入れ子カニューレ |
Family Cites Families (10)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6899672B2 (en) * | 2002-11-08 | 2005-05-31 | Scimed Life Systems, Inc. | Endoscopic imaging system including removable deflection device |
US9554691B2 (en) * | 2004-04-21 | 2017-01-31 | Acclarent, Inc. | Endoscopic methods and devices for transnasal procedures |
US7510524B2 (en) * | 2005-04-04 | 2009-03-31 | Invuity, Inc. | Optical waveguide sheath |
US8512232B2 (en) * | 2009-09-08 | 2013-08-20 | Gyrus Acmi, Inc. | Endoscopic illumination system, assembly and methods for staged illumination of different target areas |
US8888686B2 (en) * | 2009-09-23 | 2014-11-18 | Entellus Medical, Inc. | Endoscope system for treatment of sinusitis |
US20130172673A1 (en) * | 2011-12-29 | 2013-07-04 | Cook Medical Technologies Llc | Space-optimized visualization catheter |
WO2013123461A1 (en) * | 2012-02-16 | 2013-08-22 | University Of Washington Through Its Center For Commercialization | Extended depth of focus for high-resolution image scanning |
IN2014DN10854A (ja) * | 2012-05-23 | 2015-09-11 | Veritract | |
DE112014004015T5 (de) * | 2013-09-03 | 2016-07-14 | Fujifilm Corporation | Endoskopisches chirurgisches Gerät und Überrohr |
JP5865562B1 (ja) * | 2014-03-28 | 2016-02-17 | オリンパス株式会社 | 走査型内視鏡用画像処理装置 |
-
2016
- 2016-03-23 EP EP16836824.9A patent/EP3184025A4/en not_active Withdrawn
- 2016-03-23 WO PCT/JP2016/059139 patent/WO2017029832A1/ja active Application Filing
- 2016-03-23 CN CN201680002869.7A patent/CN106714653B/zh not_active Expired - Fee Related
-
2017
- 2017-03-22 US US15/466,173 patent/US20170188800A1/en not_active Abandoned
Patent Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JPH05337073A (ja) | 1992-06-04 | 1993-12-21 | Olympus Optical Co Ltd | 医療器具 |
JPH09135841A (ja) * | 1995-11-14 | 1997-05-27 | Olympus Optical Co Ltd | 気腹針 |
JP2011514202A (ja) * | 2008-03-03 | 2011-05-06 | アプライド メディカル リソーシーズ コーポレイション | バルーントロカールの新固定方式 |
JP2012505694A (ja) * | 2008-10-17 | 2012-03-08 | コーニンクレッカ フィリップス エレクトロニクス エヌ ヴィ | 連動入れ子カニューレ |
Non-Patent Citations (1)
Title |
---|
See also references of EP3184025A4 |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN110446509A (zh) * | 2016-07-25 | 2019-11-12 | 日机装株式会社 | 光导入装置以及杀菌系统 |
Also Published As
Publication number | Publication date |
---|---|
CN106714653B (zh) | 2018-10-09 |
EP3184025A4 (en) | 2018-08-29 |
EP3184025A1 (en) | 2017-06-28 |
US20170188800A1 (en) | 2017-07-06 |
CN106714653A (zh) | 2017-05-24 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
JP6950073B2 (ja) | 処置具、内視鏡装置及び内視鏡システム | |
US20150150634A1 (en) | Medical system and operation method | |
JP6214464B2 (ja) | 内視鏡システム | |
WO2015147158A1 (ja) | 内視鏡用外科手術装置、処置具、及びガイド部材 | |
US8915836B2 (en) | Endoscope, guide unit, guide wire, medical-device guiding system, and medical-device guiding method | |
JP5861002B2 (ja) | 医療器具 | |
WO2017029832A1 (ja) | 医療用シース及び医療機器 | |
JP6266756B2 (ja) | 外装管及び内視鏡用外科手術装置 | |
US20170007100A1 (en) | Endoscopic surgical device, endoscope, and endoscope operating tool | |
JP6043036B1 (ja) | 医療用シース及び医療機器 | |
KR101479686B1 (ko) | 의료용 수술 기구 | |
WO2020079824A1 (ja) | 内視鏡用処置具 | |
JPH04354929A (ja) | 内視鏡 | |
JP6602580B2 (ja) | 内視鏡システム | |
JPWO2008126434A1 (ja) | 処置具 | |
JPWO2014156244A1 (ja) | 医療器具及び医療システム | |
JP2012081055A (ja) | 内視鏡用高周波剥離ナイフ装置 | |
JP2004024618A (ja) | 蛍光観察内視鏡用処置具 | |
JP5059121B2 (ja) | 手術器具 | |
KR101620831B1 (ko) | 수술용 인스트루먼트 | |
KR20100005588U (ko) | 수술기용 조명 기구 | |
US8961411B2 (en) | Indication device | |
JP2021061870A (ja) | エネルギ処置具 | |
JPH01274753A (ja) | 接触型レーザプローブ | |
JP2005058405A (ja) | 凝固切開処置具 |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
ENP | Entry into the national phase |
Ref document number: 2016546113 Country of ref document: JP Kind code of ref document: A |
|
REEP | Request for entry into the european phase |
Ref document number: 2016836824 Country of ref document: EP |
|
WWE | Wipo information: entry into national phase |
Ref document number: 2016836824 Country of ref document: EP |
|
121 | Ep: the epo has been informed by wipo that ep was designated in this application |
Ref document number: 16836824 Country of ref document: EP Kind code of ref document: A1 |
|
NENP | Non-entry into the national phase |
Ref country code: DE |