WO2021044633A1

WO2021044633A1 - Endoscope

Info

Publication number: WO2021044633A1
Application number: PCT/JP2019/035268
Authority: WO
Inventors: 雄偉王
Original assignee: オリンパス株式会社
Priority date: 2019-09-06
Filing date: 2019-09-06
Publication date: 2021-03-11

Abstract

An endoscope 1 comprises: an operation unit 3; a long insertion unit 2 that is connected to the operation unit 3, and that is inserted into a subject of examination; a tip component 21 that has an optical window constituted of a light transmissive member, and that is disposed on a tip 6 of the insertion unit 2; a fluid supply tube 33 that is disposed in the insertion unit 2; and a nozzle 31 that is connected to the fluid supply tube 33, and that discharges, through an opening 32, a fluid supplied from the fluid supply tube 33. The nozzle 31 is disposed on the tip component 21 such that the opening 32 faces the outer diametrical direction of the tip 6 that does not include the optical window.

Description

Endoscope

The present invention relates to an endoscope provided with a nozzle for injecting a fluid at the tip of an insertion portion.

As is well known, endoscopes are widely used for observing and treating the inside of a living body (inside the body cavity), or for inspection and repair in industrial plant equipment. The endoscope has an insertion section for insertion into a flexible conduit. Such an endoscope is, for example, as disclosed in Japanese Patent Application Laid-Open No. 6-319690, a liquid for cleaning the surface of an observation window, an illumination window, or the like at the tip of an insertion portion, a gas supplied into a body cavity, or the like. An air supply / water supply nozzle that ejects the fluid of the above is provided.

By the way, in bronchial endoscopy, a local anesthetic solution such as lidocaine may be sprayed into the trachea and bronchi in order to suppress the cough reflex and vomiting reflex of the patient. Conventionally, the local anesthetic solution is sprayed through the forceps channel, but the drug solution remains in the forceps channel, or a sufficient amount of the drug solution is uniformly sprayed from the tip opening of the forceps channel to the target range. There is a problem that it is difficult.

Therefore, there is a problem that the dose of the local anesthetic solution varies greatly depending on the case and the anesthetic effect is not constant. Further, since the bronchial endoscope is inserted into a narrow bronchus, it is desired to make the insertion portion smaller in diameter.

Therefore, the present invention has been made in view of the above circumstances, and provides an endoscope capable of reducing the diameter of the insertion portion, preventing the drug solution from leaking into the body cavity, and uniformly spraying the drug solution in a target range. The purpose is.

The endoscope according to one aspect of the present invention has an operation unit, a long insertion unit connected to the operation unit and inserted into a subject, and an optical window composed of a light transmitting member of the insertion unit. A nozzle provided with a tip component disposed at the tip portion, a fluid supply tube disposed at the insertion portion, and an opening that communicates with the fluid supply tube and ejects the fluid supplied from the fluid supply tube. And, the nozzle is arranged in the tip component so that the opening faces the outer radial direction of the tip portion not including the optical window.

According to the present invention, it is possible to provide an endoscope capable of reducing the diameter of the insertion portion, preventing the drug solution from leaking into the body cavity, and uniformly spraying the drug solution in the target range.

The figure which shows the appearance of the endoscope of one aspect of this invention The same, perspective view which shows the structure of the tip part of the insertion part. The front view showing the structure of the tip of the insertion part. Partial cross-sectional view showing the tip of the insertion part inserted into the trachea and bronchus. Partial cross-sectional view showing the tip of the trachea and the bronchus along the VV line of FIG. The front view showing the structure of the tip of the insertion part having the forceps channel. Partial cross-sectional view showing the tip of the insertion portion inserted into the trachea and bronchus of the first modification. Front view showing the tip portion of the nozzle of the second modification in a state where the injection port faces the outer diameter direction. Front view showing the tip of the nozzle of the second modification in a state where the injection port faces the observation optical system. Partial sectional view showing the structure of the nozzle provided at the tip of the second modification. The figure which shows the operation part provided with the lever which rotates the nozzle of the 2nd modification. Front view showing the tip portion in a state where the rotation position is restricted by a stopper so that the injection port of the nozzle of the second modification faces the observation optical system. Front view showing the tip portion in a state where the rotation position is regulated by a stopper so that the injection port of the nozzle of the second modification faces the proof optical system. A perspective view showing the configuration of the tip portion of the insertion portion of the third modification. Front view showing the configuration of the tip of the insertion portion of the third modification. Partial sectional view which shows the structure of the nozzle provided in the tip part of the 3rd modification. The figure which shows the operation part provided with the lever and the pedestal which rotate and advance / retreat the nozzle of the 3rd modification. Perspective view showing the configuration of the tip portion of the insertion portion of the fourth modified example. Front view showing the configuration of the tip portion of the fourth modification Partial sectional view showing the structure of the tip part provided with the nozzle of the 4th modification. Partial sectional view which shows the structure of the nozzle provided in the tip part of the 5th modification. Top view showing the structure of the nozzle provided at the tip of the fifth modification. Partial cross-sectional view showing a state in which the cleaning liquid is ejected from the first injection port of the nozzle of the fifth modification. Partial sectional view showing a state in which a local anesthetic solution is ejected from the second injection port of the nozzle of the fifth modification.

Hereinafter, one aspect of the tip unit of the endoscope and the endoscope according to the present invention will be described. In the following description, the drawings based on each embodiment are schematic, and the relationship between the thickness and width of each part, the ratio of the thickness of each part, and the like are different from the actual ones. It should be noted that the drawings may include parts having different dimensional relationships and ratios from each other.
Further, the endoscope in the following configuration description exemplifies a so-called bronchoscope having a small-diameter insertion portion and used for examination and treatment of trachea, bronchus, etc., but is not limited thereto. This technique can be applied to a so-called flexible endoscope having a flexible insertion portion for insertion into the digestive organs above or below the living body, and a so-called rigid endoscope having a rigid insertion portion used for surgery.

Hereinafter, an endoscope according to one aspect of the present invention will be described with reference to the drawings.
As shown in FIG. 1, the endoscope 1, which is an electronic endoscope of the present embodiment, has a long insertion portion 2 having an outer diameter of about 3 to 4 mm and a base of the insertion portion 2. Mainly composed of an operation unit 3 connected to the end, a universal cord 4 which is an endoscope cable extending from the operation unit 3, and an endoscope connector 5 arranged at the tip of the universal cord 4. It is configured in.

The insertion portion 2 is a tubular member having flexibility formed by connecting the tip portion 6, the curved portion 7, and the flexible tube portion 8 in this order from the tip side. Of these, an imaging means, a lighting means, and the like are housed and arranged at the tip portion 6.
The curved portion 7 is a mechanical portion of the operating member of the operating portion 3 that is configured to be able to be actively curved in two vertical directions (UP-DOWN) of the inserting portion 2 by the rotation operation of the bending lever 13. is there.

The curved portion 7 is not limited to a type that actively curves in two vertical directions, and the curved portion 7 is not limited to a type that actively bends in two vertical directions, and the curved portion 7 is not limited to a type that actively bends in two vertical directions. It may be of a type that can be curved in the circumferential direction (UP-DOWN / LEFT-RIGHT).

Further, the bending portion 7 may be of a type capable of bending only in one direction in the upward (UP) direction, and further, does not have a mechanism for actively bending by the bending lever 13, and simply passively bends. It may be of the type.

The flexible tube portion 8 is a tubular member formed with flexibility so as to be passively flexible. The inside of the flexible tube portion 8 extends from an imaging device (not shown) built in the tip portion 6 and further extends from the operating portion 3 to the inside of the universal cord 4 from an imaging cable and a light source device. A light guide bundle or the like, which will be described later, for guiding the illumination light of the above and emitting it from the tip portion 6 is inserted (these are not shown here).

The operation unit 3 is provided on the tip side and covers the base end of the flexible pipe portion 8 and is connected to the flexible pipe portion 8. It has a grip portion 10 that is gripped by hand when the mirror 1 is used.

The operation unit 3 includes, as the endoscope operating means, a plurality of various switches 14 for performing each corresponding operation such as a bending lever 13 for performing a bending operation of the bending portion 7, an imaging means, a lighting means, and a liquid feeding tube. Is connected to provide a fluid supply port 15 to which a chemical solution or the like is supplied by a syringe or the like.

The universal cord 4 is a light guide bundle that transmits illumination light from a signal cable bundle, a light source device (not shown), etc. from the tip portion 6 of the insertion portion 2 through the inside of the insertion portion 2 to reach the operation unit 3. Is a composite cable inserted.

The endoscope connector 5 has an electric connector portion 16 on the side surface to which a signal cable for connecting to a video processor (not shown) of an external device is connected, and also connects to a light source device which is an external device. It is configured to include a light source connector portion 17 having a light source connection plug 18 to which a light guide bundle described later and an electric cable (not shown) are connected.

Here, the configuration of the tip portion of the insertion portion 2 of the endoscope 1 of the present embodiment will be described below based on FIGS. 2 and 3. In the following description, the description of the well-known configuration of the insertion portion 2 will be omitted.

As shown in FIGS. 2 and 3, the tip portion 6 of the insertion portion 2 has a tip frame main body 21 as a tip component made of metal or resin. The tip frame main body 21 is provided with a tip cap 23.

Observation light having an optical axis O substantially parallel to the longitudinal axis X of the linear insertion portion 2 is incident on the tip surface 22 of the tip cap 23. Here, it is an optical window of a substantially circular light transmitting member and is built in. An observation optical system 24 arranged at the tip of an imaging device (not shown), an illumination optical system 25 which is an optical window of a substantially circular light transmitting member, and a chemical solution for ejecting a fluid such as a chemical solution or air. The nozzle 31 as a spraying portion is provided so as to be exposed. The observation optical system 24 and the illumination optical system 25 are not limited to one, and may be plural.

The outer peripheral portion of the base end of the tip frame main body 21 is covered with the tip portion of the curved rubber 28 which is the outer skin of the curved portion 7. The curved rubber 28 is provided with a pincushion adhesive portion 27 on the outer periphery of the tip portion, and is fixed to the base end outer peripheral portion of the tip frame main body 21.

The nozzle 31 is made of a metal such as stainless steel, and is provided so that the injection port 32, which is an opening for ejecting a fluid, faces substantially the opposite side of the observation optical system 24. That is, the injection port 32 faces a direction that does not include the observation optical system 24, and the fluid injected from the injection port 32 is in the outer peripheral (outer diameter) direction of the tip portion 6 that is substantially orthogonal to the longitudinal axis X of the insertion portion 2. The orientation of the nozzle 31 is set as described above.

Further, here, the injection direction of the nozzle 31 from the injection port 32 is substantially orthogonal to the opening surface of the injection port 32, is on the opposite side of the observation optical system 24, and is the center of the observation optical system 24 (the optical axis O passes through). It is set to be in the direction along the line passing through the point) (in the direction of the arrow line R in the figure).

One end of a fluid supply tube 33 (see FIG. 4) as a liquid feeding tube is communicated with the nozzle 31. The fluid supply tube 33 is arranged in the insertion portion 2 and the operation portion 3, and the other end thereof is communicated with the fluid supply port 15 (see FIG. 1) provided in the operation portion 3.

In the endoscope 1 configured in this way, as shown in FIGS. 4 and 5, the insertion portion 2 is inserted into, for example, the trachea and the airway of the bronchus 100. At this time, a local anesthetic solution such as lidocaine is administered in order to suppress the cough reflex and vomiting reflex of the patient.

When the local anesthetic solution is administered to the trachea and bronchus 100, the local anesthetic solution is injected into the fluid supply tube 33 from the fluid supply port 15 using a syringe or the like to form the airways of the trachea and bronchus 100 from the nozzle 31. A local anesthetic solution is sprayed toward the mucous membrane of the tracheal (bronchial) wall. Then, the local anesthetic solution is sprayed on the mucous membrane of the tracheal (bronchial) wall from the injection port 32 of the nozzle 31 facing the outer diameter direction of the tip portion 6.

As described above, the endoscope 1 of the present embodiment is different from the conventional configuration in which the local anesthetic solution is sprayed on the mucous membrane of the tracheal (bronchial) wall by using the forceps channel, and the tip portion 6 of the insertion portion 2 is used. It is configured so that it can be sprayed on the mucous membrane of the tracheal (bronchial) wall from the injection port 32 of the nozzle 31 facing the outer radial direction of.

As a result, a predetermined amount of the drug solution is uniformly applied to the area of the mucous membrane of the target tracheal (bronchial) wall without leaking the local anesthetic solution from the opening of the forceps channel or leaving the drug solution in the treatment tool channel. Can be sprayed on. As a result, the dose of the local anesthetic solution can be easily controlled, and the anesthetic effect can be kept constant.

Further, since the endoscope 1 does not require a forceps channel for spraying the local anesthetic solution, the insertion portion 2 is further reduced in diameter if only the examination is performed without requiring the treatment of the trachea and the bronchus 100. can do. As shown in FIG. 6, the endoscope 1 may have a forceps channel 26.

(First modification)
As shown in FIG. 7, the endoscope 1 may have a predetermined angle θ so that the injection port 32 of the nozzle 31 faces the tip side with respect to the direction orthogonal to the longitudinal axis X of the insertion portion 2. Good.

Thereby, the endoscope 1 can be performed while observing the injection state and the spraying state of the local anesthetic solution from the injection port 32 of the nozzle 31 in a predetermined range of the mucous membrane of the tracheal (branch) wall.

(Second modification)
As shown in FIGS. 8 and 9, the nozzle 31 is rotatable so that the injection port 32 can be changed in the direction facing the outer diameter of the tip portion 6 and the direction facing the observation optical system 24, the illumination optical system 25, and the like. It may be configured as such.

The endoscope 1 of this modified example has a configuration in which the nozzle 31 is rotatable so that the injection direction of the fluid from the injection port 32 of the nozzle 31 (R direction along the arrow line in the figure) can be changed.

As shown in FIG. 10, the nozzle 31 here is rotatably arranged so as to be inserted into the hole 29 of the tip frame main body 21 around the longitudinal axis C. A flange 34 is formed in a portion of the nozzle 31 accommodated in the tip frame main body 21, and a sealing member 35 such as an O-ring is provided on the outer peripheral portion of the flange 34.

One end of the fluid supply tube 33 is connected to the base end portion of the nozzle 31. Then, the coil tube 37 in which the metal wire that transmits the rotational power to the nozzle 31 and prevents the fluid supply tube 33 from being twisted to the extent that the flexibility of the insertion portion 2 is not impaired is tightly wound around the outer circumference of the fluid supply tube 33. It is provided so as to cover the part.

As shown in FIG. 11, the operation unit 3 is provided with a lever 11 which is an operation member for rotating the nozzle 31.

The endoscope 1 of this modified example is configured so that the nozzle 31 can be rotated around the longitudinal axis C, and in addition to spraying the local anesthetic solution on the mucous membrane of the tracheal (branch) wall, from the injection port 32 of the nozzle 31. A cleaning solution such as physiological saline can be sprayed onto the observation optical system 24 and the illumination optical system 25 for cleaning.

Further, since the nozzle 31 is rotatable, when the local anesthetic solution is sprayed on the mucous membrane of the tracheal (bronchial) wall, the local anesthetic solution is applied to the entire circumference of the tracheal (bronchial) wall without twisting the insertion portion 2. It can be easily sprayed.

Further, as shown in FIGS. 12 and 13, the nozzle 31 abuts and rotates so that the injection direction of the fluid from the injection port 32 (R direction along the arrow line in the figure) is the observation optical system 24 and the illumination optical system 25. A stopper 37, which is a protrusion whose moving position is defined, may be provided on the tip surface 22.

Further, the operation unit 3 may be provided with an index that allows the injection direction of the fluid from the nozzle 31 depending on the operation position of the lever 11 to be confirmed at hand.

(Third variant)
As shown in FIGS. 14 and 15, the nozzle 31 may have a structure that is rotatable and that can be moved forward and backward so as to extend from the tip portion 6 to a predetermined length.

The nozzle 31 here has a hard tube portion 36 formed of a metal such as stainless steel having an outer diameter of about 1 mm. The nozzle 31 is set so that the length L2 along the longitudinal axis C of the hard pipe portion 36 is shorter (L1> L2) than the hard length L1 of the tip portion 6.

That is, since the hard pipe portion 36 does not reach the inside of the curved portion 7 when the nozzle 31 is not extended, the bending operation of the curved portion 7 is not affected.

As shown in FIG. 16, the nozzle 31 here has the same configuration as the second modification except that it has a hard pipe portion 36 having a predetermined length L2.

As shown in FIG. 17, the operation unit 3 is provided with a rotation lever 12 which is an operation member for moving the nozzle 31 forward and backward, and the pedestal 13 provided with the rotation lever 12 is used for the operation unit 3. The nozzle 31 is configured to rotate around the longitudinal axis C by rotating the nozzle 31 around the longitudinal axis Y.

In addition to the effects of the second modification, the endoscope 1 of this modification is configured so that the nozzle 31 can be moved forward and backward along the longitudinal axis C so as to extend from the tip portion 6. Local anesthetic solution can be sprayed on the mucous membrane of the tracheal (bronchial) wall.

Further, since the nozzle 31 can move forward and backward, the local anesthetic solution is applied to the mucous membrane of the tracheal (bronchial) wall in the entire circumference of the tracheal (bronchial) wall and in the anterior-posterior direction without pushing and pulling the insertion portion 2. Can be easily sprayed.

(Fourth modification)
As shown in FIGS. 18 to 21, the tip surface 22 of the tip cap 23 of this modification may have a stepped portion 22a as a recess in the portion where the nozzle 31 is arranged. The step portion 22a is formed up to the outer peripheral portion of the tip cap 23 along the direction in which the injection port 32 of the nozzle 31 faces.

With the configuration of forming the concave step portion 22a in which the nozzle 31 is provided on the tip surface 22 in this way, the local anesthetic solution sprayed from the injection port 32 of the nozzle 31 does not flow to the observation optical system 24 side, and the field of view is secured. , It is possible to prevent the obstruction of visibility.

(Fifth variant)
As shown in FIGS. 21 and 22, the nozzle 50 of this modification has a first opening 51 facing the direction of the observation window and a second opening facing the opposite side of the first injection port 51. The second injection port 52 is provided with two openings at both ends.

The nozzle 50 has a first flow path 51a communicating with the first injection port 51 and a second flow path 52a communicating with the second injection port 52, and these first flow paths 51a and the second flow path 52a. The flow path 52a is partitioned by the partition wall 54. The nozzle 50 is formed up to an intermediate portion of the tubular portion in which the partition wall 54 is inserted into the tip cap 23, and the first flow path 51a and the second flow path 52a communicate with each other at the base end portion. ..

A substantially cylindrical rotating portion 53 as a switching member rotatably held from the partition wall 54 to the base end side is inserted in the tubular portion of the nozzle 50. The rotating portion 53 is integrally formed with the flange 34 provided with the seal member 35, and the fluid supply tube 33 is connected to the proximal end side of the flange 34.

An opening is formed in the tip surface of the rotating portion 53 so that when communicating with either the first flow path 51a or the second flow path 52a depending on the rotation position, the rotating portion 53 does not communicate with the other. The flow path 53a of 3 is formed. The third flow path communicates with the fluid supply tube 33.

With the above configuration, by rotating the fluid supply tube 33 covered with the coil tube 37, the rotating portion 53 in the tubular portion of the nozzle 50 is rotated, and the opening of the third flow path 53a is opened. It fits into the first flow path 51a or the second flow path 52a, and the third flow path 53a communicates with either the first flow path 51a or the second flow path 52a.

As a result, the fluid supply tube 33 communicates with either the first flow path 51a or the second flow path 52a according to the rotation position of the rotating portion 53.

Therefore, as shown in FIG. 23, when the third flow path 53a communicates with the first flow path 51a, the cleaning liquid R1 such as physiological saline sent from the fluid supply tube 33 is transferred to the first nozzle 50. Can be cleaned by injecting into the observation optical system 24 and the illumination optical system 25 from the injection port 51 of the above.

On the other hand, as shown in FIG. 24, when the third flow path 53a communicates with the second flow path 52a and the third flow path 53a communicates with the second flow path 52a, the fluid supply tube The local anesthetic solution R2 sent from 33 can be sprayed from the second injection port 52 of the nozzle 50 to the entire circumference of the tracheal (branch) wall.

The inventions described in the above embodiments and modifications are not limited to those embodiments and modifications, and various modifications can be carried out at the implementation stage without departing from the gist thereof. .. Further, the above-described embodiments and modifications include inventions at various stages, and various inventions can be extracted by an appropriate combination of a plurality of disclosed constituent requirements.

For example, if some of the constituents are removed from all the constituents shown in the embodiments and modifications, but the stated problems can be solved and the stated effects can be obtained, the constituents are found. The configuration in which is deleted can be extracted as an invention.

Claims

Operation unit and
A long insertion part connected to the operation part and inserted into the subject,
A tip component having an optical window made of a light transmitting member and arranged at the tip of the insertion portion,
A fluid supply tube arranged in the insertion portion and
A nozzle having an opening that communicates with the fluid supply tube and ejects the fluid supplied from the fluid supply tube.
Equipped with
The endoscope is an endoscope characterized in that the nozzle is arranged in the tip component so that the opening faces the outer diameter direction of the tip portion not including the optical window.
The endoscope according to claim 1, wherein the direction in which the opening faces is substantially opposite to the optical window.
The nozzle is rotatably arranged around a longitudinal axis so that the direction in which the opening faces can be changed.
The endoscope according to claim 1, wherein an operating member for rotating the nozzle is provided in the operating portion.
The endoscope according to claim 3, wherein a stopper that comes into contact with the nozzle and defines the direction in which the opening faces the optical window is provided at the tip portion.
The nozzle is arranged so as to be able to advance and retreat in the longitudinal axis direction so as to extend from the tip portion.
The endoscope according to claim 1, wherein an operating member for moving the nozzle forward and backward is provided in the operating unit.
The nozzle is arranged so as to be rotatable around the longitudinal axis so that the direction in which the opening faces can be changed, and to be movable back and forth in the longitudinal axis direction so as to extend from the tip portion.
The endoscope according to claim 1, wherein an operation member for rotating and advancing / retreating the nozzle is provided in the operation unit.
The tip component is formed with a recess along the direction in which the opening faces.
The endoscope according to claim 2, wherein the nozzle is housed in the recess.
The endoscope according to claim 1, wherein the nozzle has a second opening facing the direction including the optical window, which is different from the opening facing the outer diameter direction of the tip portion.
8. The nozzle is provided with a switching member for switching between a state in which the opening communicates with the fluid supply tube and a state in which the second opening communicates with the fluid supply tube. The endoscope described.