WO2021157637A1 - Endoscope à passage lacrymal - Google Patents

Endoscope à passage lacrymal Download PDF

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Publication number
WO2021157637A1
WO2021157637A1 PCT/JP2021/004033 JP2021004033W WO2021157637A1 WO 2021157637 A1 WO2021157637 A1 WO 2021157637A1 JP 2021004033 W JP2021004033 W JP 2021004033W WO 2021157637 A1 WO2021157637 A1 WO 2021157637A1
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WO
WIPO (PCT)
Prior art keywords
insertion portion
pipe
lacrimal
tube
tip
Prior art date
Application number
PCT/JP2021/004033
Other languages
English (en)
Japanese (ja)
Inventor
憲昭 金澤
Original Assignee
ニプロ株式会社
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by ニプロ株式会社 filed Critical ニプロ株式会社
Priority to JP2021575847A priority Critical patent/JPWO2021157637A1/ja
Publication of WO2021157637A1 publication Critical patent/WO2021157637A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes

Definitions

  • the present invention relates to a lacrimal duct endoscope.
  • Lacrimal duct endoscopes used for lacrimal duct examination or treatment have been developed (for example, Patent Document 1-3).
  • a lacrimal duct endoscope as shown in Patent Document 1-3 is provided with an insertion portion that can be inserted into the lacrimal duct of a patient.
  • the insertion portion is tubular, and at its tip, a light that illuminates the inspection target, an objective lens that collects the light reflected on the surface of the inspection target, and the like are provided.
  • the outer diameter of the insertion portion is the value shown in Patent Documents 1-3
  • the user may find it difficult to insert the insertion portion into the lacrimal passage of the patient. Therefore, it is conceivable to make the insertion portion thinner.
  • the length of the insertion portion is the value shown in Patent Documents 1-3
  • an object of the present invention is to provide a technique for improving the operability of the lacrimal duct endoscope and suppressing deformation of the shape of the lacrimal duct endoscope.
  • the present invention adopts the following configuration in order to solve the above-mentioned problems.
  • the lacrimal duct endoscope has a tubular insertion portion that can be inserted into the lacrimal passage and a holding portion that holds the base end of the insertion portion, and the insertion portion can be operated.
  • the outer diameter of the insertion portion is 0.6 mm or more and 0.7 mm or less, and is substantially uniform over the longitudinal direction, and the length of the insertion portion is 16 mm or more and 40 mm or less.
  • the outer diameter of the insertion portion is thin and substantially uniform, so that the user can easily insert the insertion portion into the lacrimal passage of the patient. Further, since the length of the insertion portion is short, the operability of the insertion portion is improved. Therefore, it is suppressed that the tip of the insertion portion is caught on the inner wall of the lacrimal passage while the insertion portion is being inserted into the lacrimal passage. Even if the tip of the insertion part is caught on the inner wall of the lacrimal passage, the length of the insertion part is short, so the bending caused by the force reacting from the inner wall of the lacrimal passage to the tip of the insertion part causes bending in the insertion part. The moment will be small. Therefore, the deformation of the lacrimal duct endoscope is suppressed.
  • the first tube provided inside the insertion portion along the longitudinal direction of the insertion portion, and the first tube through which the light incident from the tip of the insertion portion passes.
  • a second tube provided inside the insertion section along the longitudinal direction of the insertion section and through which the fluid flowing out from the tip of the insertion section passes, is further provided, and the insertion section, the first tube, and the second tube are provided.
  • the tubes are each made of a material containing metal, and the first tube and the second tube may be provided so as to be in contact with the inner wall of the insertion portion and to be in contact with each other.
  • the insertion portion, the first pipe, and the second pipe are each made of a material containing metal, the rigidity of the insertion portion, the first pipe, and the second pipe is improved. Further, the first tube and the second tube are provided so as to be in contact with the inner wall of the insertion portion and to be in contact with each other. Therefore, the insertion portion, the first pipe, and the second pipe can integrally counter the bending moment generated in the insertion portion. Therefore, the deformation of the insertion portion, the first tube and the second tube is suppressed.
  • the first tube and the second tube are provided side by side in the radial direction of the insertion portion, and the cross section orthogonal to the longitudinal direction of the second tube is substantially a cross section.
  • a semicircular, substantially semicircular straight line portion may be in contact with the first tube.
  • the cross-sectional area of the second pipe can be increased without changing the thickness of the insertion portion, and the flow rate of the fluid passing through the second pipe can be increased.
  • the holding portion may have an elastic member provided so as to cover the outer surface of the base end of the insertion portion.
  • the tip of the insertion part When the tip of the insertion part is caught on the inner wall of the lacrimal passage and presses the inner wall, a force acts from the inner wall of the lacrimal passage to the tip of the insertion part, and a bending moment is generated in the insertion part. Further, the magnitude of the bending moment generated at the base end of the insertion portion is larger than the magnitude of the bending moment generated at the tip or center of the insertion portion. Therefore, it is considered that the possibility that the base end of the insertion portion is deformed increases. However, according to this configuration, when the base end of the insertion portion is about to be deformed, the elastic member covering the outer surface of the base end of the insertion portion is deformed, and the deformation of the base end of the insertion portion is suppressed.
  • the ratio of the length of the insertion portion to the outer diameter of the insertion portion may be in the range of 22 times to 37 times.
  • the ratio of the length of the insertion part to the outer diameter of the insertion part is within the above range, the tip of the insertion part is caught on the inner wall of the lacrimal passage, and a force acts from the inner wall of the lacrimal passage to the tip of the insertion part to insert the insertion part. Even when a bending moment is generated in the portion, it is possible to secure an outer diameter of the insertion portion that is sufficiently large with respect to the value of the generated bending moment. As a result, deformation of the insertion portion is suppressed.
  • the present invention it is possible to provide a technique for improving the operability of the lacrimal duct endoscope and suppressing deformation of the shape of the lacrimal duct endoscope.
  • FIG. 1 shows an example of the configuration of the lacrimal duct endoscope according to the embodiment.
  • FIG. 2 shows an outline of an enlarged view of the tip of the insertion portion.
  • FIG. 3 illustrates a partially enlarged view of the cross section of the holding portion.
  • FIG. 4 shows the situation when a lacrimal duct endoscope is used.
  • FIG. 1 shows an example of the configuration of the lacrimal duct endoscope 1 according to the embodiment of the present invention.
  • the lacrimal duct endoscope 1 includes an insertion portion 2.
  • the outer shape of the insertion portion 2 is formed by a highly rigid stainless steel outer pipe 7 (detailed in FIG. 2).
  • the outer pipe 7 is a cylindrical member, has a total length of 18 mm, and has an outer diameter of 0.7 mm.
  • the size of the outer diameter is substantially uniform over the entire length of the outer pipe 7.
  • the outer pipe 7 includes a portion that extends linearly from the base end toward the tip end and a portion that curves in a predetermined direction during the stretching. Since such an insertion portion 2 has a small outer diameter and is substantially uniform, it can be easily inserted into the patient's lacrimal canaliculi 52 (see FIG. 4 described later).
  • the lacrimal duct endoscope 1 includes an operation unit 3 capable of operating the insertion unit 2.
  • the operation unit 3 has a thickness that can be grasped by the user.
  • the operation unit 3 includes a holding unit 4 that holds and fixes the base end of the insertion unit 2.
  • the user grips such an operation unit 3 to operate the insertion unit 2, but since the length of the insertion unit 2 is as short as 18 mm, the operability of the insertion unit 2 that the user feels is high. Therefore, it is suppressed that the tip of the insertion portion 2 is caught on the inner wall of the canaliculi 52 while the insertion portion 2 is being inserted into the canaliculi 52. Further, even when the tip of the insertion portion 2 is caught on the inner wall of the canaliculi 52, since the length of the insertion portion 2 is short, a force acts from the inner wall of the canaliculi 52 to the tip of the insertion portion 2. The bending moment generated in the insertion portion 2 is small. Therefore, the deformation of the lacrimal duct endoscope 1 is suppressed.
  • the operation unit 3 includes a first connection unit 5 to which a supply pipe through which a physiological saline solution (an example of the fluid of the present invention) supplied from an external device passes is connected. Further, the operation unit 3 includes a second connection unit 6 to which a transmission cable for transmitting and receiving light is connected to and from an external imaging system.
  • FIG. 2 shows an outline of an enlarged view of the tip of the insertion portion 2 as viewed from the longitudinal direction.
  • the insertion portion 2 has a light guide 8 inside the outer pipe 7.
  • the light guide 8 is, for example, a bundle of a plurality of optical fibers for illumination, and is provided along the longitudinal direction of the outer pipe 7. Further, the light guide 8 extends to the inside of the operation unit 3, and its tip is connected to the second connection unit 6. That is, the light supplied from the external imaging system passes through the inside of the light guide 8 via the second connection portion 6. Then, the light that has passed through the light guide 8 irradiates the surface of the observation object.
  • the insertion portion 2 has an image fiber pipe 9 inside the outer pipe 7.
  • the image fiber pipe 9 is a highly rigid stainless steel cylindrical member, and is provided so as to be in contact with the inner wall of the outer pipe 7. Further, a plurality of image fibers 10 are provided inside the image fiber pipe 9 along the longitudinal direction. A lens 11 is provided at the tip of the image fiber pipe 9.
  • the lens 11 is irradiated from the tip of the light guide 8 and collects the light reflected on the surface of the observation object. Then, the light collected by the lens 11 passes through the image fiber 10. Further, the image fiber 10 extends to the inside of the operation unit 3, and its tip is connected to the second connection unit 6. That is, the light that has passed through the image fiber 10 is transmitted to an external imaging system.
  • the image fiber pipe 9 is an example of the "first pipe" of the present invention.
  • the insertion portion 2 has a channel pipe 12 inside the outer pipe 7.
  • the channel pipe 12 is a highly rigid stainless steel tubular member, and the shape of the cross section orthogonal to the longitudinal direction is substantially semicircular.
  • the channel pipe 12 is provided so as to be aligned with the image fiber pipe 9 in the radial direction of the outer pipe 7.
  • the channel pipe 12 is provided so that a substantially semicircular straight line portion is in contact with the outer surface of the image fiber pipe 9, and a substantially semicircular arc portion is provided so as to be in contact with the inner wall of the outer pipe 7. .. Therefore, the insertion portion 2, the image fiber pipe 9, and the channel pipe 12 can integrally counter the bending moment generated in the insertion portion 2. Therefore, deformation of the insertion portion 2, the image fiber pipe 9, and the channel pipe 12 is suppressed.
  • the channel pipe 12 is an example of the "second pipe" of the present invention.
  • a water passage channel 13 is provided along the longitudinal direction.
  • the water flow channel 13 extends to the inside of the operation unit 3, and its tip is connected to the first connection unit 5. That is, the physiological saline solution supplied from the external device via the first connection portion 5 flows into the water passage channel 13. These physiological saline solutions can flow out from the tip of the water passage channel 13 on the insertion portion 2 side.
  • the operation unit 3 is operated to allow physiological saline to flow in from an external device via the first connection unit 5 and to flow out from the tip of the water flow channel 13 on the insertion unit 2 side to the outside.
  • the water flow operation unit is provided.
  • the cross section orthogonal to the longitudinal direction of the channel pipe 12 is substantially semicircular, and the substantially semicircular straight line portion is in contact with the outer surface of the image fiber pipe 9.
  • the channel does not change the size of the diameter of the outer pipe 7 of the insertion portion 2 as compared with the case where the channel pipe 12 having a circular cross section is used.
  • the cross-sectional area of the pipe 12 can be increased. Therefore, the flow path area of the water flow channel 13 can be increased, and the flow rate of the physiological saline passing through the water flow channel 13 can be increased.
  • FIG. 3 illustrates a partially enlarged view of a cross section parallel to the longitudinal direction of the holding portion 4.
  • the holding portion 4 includes a hole 14 through which the base end of the inserting portion 2 can be inserted. Then, in the radial direction of the insertion portion 2, a gap is provided between the outer wall of the insertion portion 2 and the inner wall of the hole 14, and the gap is filled by the damper 15.
  • the damper 15 is an elastic member that can expand and contract in the radial direction of the insertion portion 2.
  • the tip of the insertion portion 2 when the tip of the insertion portion 2 is caught on the inner wall of the canaliculi 52 and a force acts from the inner wall of the canaliculi 52 to the tip of the insertion portion 2, the tip of the insertion portion 2 or the tip of the insertion portion 2 is attached to the base end of the insertion portion 2. It is conceivable that a bending moment larger than the bending moment generated in the center is generated. Therefore, it is considered that the base end of the insertion portion 2 is more easily deformed than the tip end or the center of the insertion portion 2. However, when the base end of the insertion portion 2 is about to be deformed, the damper 15 is elastically deformed, so that the deformation of the base end of the insertion portion 2 is suppressed.
  • FIG. 4 shows the situation when the lacrimal duct endoscope 1 is used.
  • the user grasps the operation unit 3 of the lacrimal duct endoscope 1 and inserts the tip of the insertion unit 2 into the lacrimal canaliculi 52 from one of the two puncta 51 located near the eye.
  • the sum of the total length of the canaliculi 52 and the width of the lacrimal sac 53 is, for example, 12 mm to 16 mm. Degree. Therefore, when the insertion of the insertion portion 2 having a total length of about 18 mm is further advanced, the tip of the insertion portion 2 reaches the lacrimal sac 53.
  • the light passing through the light guide 8 irradiates the inner wall surface of the canaliculi 52 or the lacrimal sac 53.
  • the light reflected on the inner wall surface of the canaliculi 52 or the lacrimal sac 53 is collected through the lens 11.
  • the light collected by the lens 11 passes through the image fiber 10.
  • the light that has passed through the image fiber 10 is transmitted to an external imaging system.
  • an image of the outer wall surface of the canaliculi 52 or the lacrimal sac 53 is imaged from the transmitted light.
  • the user operates the water flow operation unit of the operation unit 3 while the insertion unit 2 is inserted into the lacrimal canaliculi 52, and the physiological saline solution is made to flow in from the external device via the first connection unit 5 and inserted.
  • the physiological saline can be discharged from the tip of the water flow channel 13 on the part 2 side.
  • the physiological saline flows into the canaliculi 52, and the canaliculi 52 are expanded. Therefore, the insertion portion 2 is smoothly inserted into the canaliculi 52.
  • the canaliculi 52 are washed with physiological saline. Therefore, the image of the canaliculi 52 or the lacrimal sac 53 can be obtained more clearly.
  • the total length of the insertion portion 2 is 18 mm, but the total length of the insertion portion 2 may be in the range of 16 mm or more and 40 mm or less.
  • the surface of the inner wall of the canaliculi 52 or the lacrimal sac 53 is imaged as shown in FIG. 4, but the total length of the insertion portion 2 is in the range of 16 mm to 40 mm, and the above embodiment
  • the insertion portion 2 can be inserted up to the nasolacrimal duct 54 (FIG. 4) to suitably image the inner wall surface of the nasolacrimal duct 54.
  • the outer diameter of the insertion portion 2 may be in the range of 0.6 mm or more and 0.7 mm or less. Further, when the range of the total length of the insertion portion 2 is determined as described above, the insertion portion is provided so that the ratio of the length of the insertion portion 2 to the outer diameter of the insertion portion 2 falls within the range of 22 to 37 times.
  • the outer diameter of 2 may be set.
  • the outer diameter of the insertion portion 2 When the outer diameter of the insertion portion 2 is set in this way, the ratio of the length of the insertion portion 2 to the outer diameter of the insertion portion 2 is suppressed, so that the tip of the insertion portion 2 is caught by the inner wall of the tear canal 52 and the insertion portion Even when a bending moment is generated in 2, it is possible to secure an outer diameter of the insertion portion that is sufficiently large with respect to the value of the generated bending moment. Therefore, the deformation of the insertion portion 2 is suppressed.
  • the 22-fold ratio described above corresponds to the case where the outer diameter of the outer pipe 7 is 0.7 mm and the total length is 16 mm.
  • the above 37-fold ratio is the sum of the maximum value of 16 mm, which is the sum of the total length of the canaliculi 52 and the width of the lacrimal sac 53, and the minimum length of the lacrimal sac, 6 mm, with the outer diameter of the outer pipe 7 being 0.6 mm and the total length being 22 mm. ) Corresponds to the case.
  • the outer pipe 7, the image fiber pipe 9, and the channel pipe 12 may be formed of a metal material different from stainless steel. Further, at least one of the outer pipe 7, the image fiber pipe 9, and the channel pipe 12 does not have to be made of metal. Further, the inner wall of the outer pipe 7, the outer wall of the image fiber pipe 9, and the outer wall of the channel pipe 12 do not have to be provided so as to be in contact with each other, and the cross-sectional shape of the channel pipe 12 with respect to the longitudinal direction does not have to be semicircular. .. Further, the damper 15 may not be provided around the base end of the insertion portion 2 in the holding portion 4.
  • Lacrimal punctal endoscope 2 Insertion part 3: Operation part 4: Holding part 5: First connection part 6: Second connection part 7: Outer pipe 8: Light guide 9: Image fiber pipe 10: Image fiber 11: Lens 12: Channel pipe 13: Water flow channel 14: Hole 15: Damper 51: Lacrimal punctum 52: Lacrimal canaliculi 53: Lacrimal sac 54: Nasolacrimal duct

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • General Health & Medical Sciences (AREA)
  • Physics & Mathematics (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Biophysics (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Optics & Photonics (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Ophthalmology & Optometry (AREA)
  • Endoscopes (AREA)

Abstract

La présente invention concerne un endoscope à passage lacrymal pourvu d'une partie d'insertion tubulaire insérable dans un passage lacrymal et d'une partie d'actionnement qui a une partie de maintien pour maintenir l'extrémité de base de la partie d'insertion et peut actionner la partie d'insertion. Le diamètre externe de la partie d'insertion est de 0,6 à 0,7 mm inclus et est sensiblement uniforme le long de la direction longitudinale, et la longueur de la partie d'insertion est de 16 à 40 mm inclus.
PCT/JP2021/004033 2020-02-05 2021-02-04 Endoscope à passage lacrymal WO2021157637A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
JP2021575847A JPWO2021157637A1 (fr) 2020-02-05 2021-02-04

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2020-018077 2020-02-05
JP2020018077 2020-02-05

Publications (1)

Publication Number Publication Date
WO2021157637A1 true WO2021157637A1 (fr) 2021-08-12

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PCT/JP2021/004033 WO2021157637A1 (fr) 2020-02-05 2021-02-04 Endoscope à passage lacrymal

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JP (1) JPWO2021157637A1 (fr)
WO (1) WO2021157637A1 (fr)

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2002071991A2 (fr) * 2001-03-13 2002-09-19 Optosgroup S.P.A. Unite et procede d'endoscopie par voie lacrymale
JP2004016317A (ja) * 2002-06-13 2004-01-22 Fibertech Co Ltd 涙道内視鏡
JP2016123718A (ja) * 2015-01-05 2016-07-11 ファイバーテック株式会社 硬性内視鏡
JP2016209448A (ja) * 2015-05-13 2016-12-15 ファイバーテック株式会社 涙道内視鏡

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2002071991A2 (fr) * 2001-03-13 2002-09-19 Optosgroup S.P.A. Unite et procede d'endoscopie par voie lacrymale
JP2004016317A (ja) * 2002-06-13 2004-01-22 Fibertech Co Ltd 涙道内視鏡
JP2016123718A (ja) * 2015-01-05 2016-07-11 ファイバーテック株式会社 硬性内視鏡
JP2016209448A (ja) * 2015-05-13 2016-12-15 ファイバーテック株式会社 涙道内視鏡

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