WO2021176570A1 - Système d'endoscope et procédé pour faire fonctionner un endoscope - Google Patents

Système d'endoscope et procédé pour faire fonctionner un endoscope Download PDF

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Publication number
WO2021176570A1
WO2021176570A1 PCT/JP2020/008978 JP2020008978W WO2021176570A1 WO 2021176570 A1 WO2021176570 A1 WO 2021176570A1 JP 2020008978 W JP2020008978 W JP 2020008978W WO 2021176570 A1 WO2021176570 A1 WO 2021176570A1
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WO
WIPO (PCT)
Prior art keywords
endoscope
curved
bending
curved member
channel
Prior art date
Application number
PCT/JP2020/008978
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English (en)
Japanese (ja)
Inventor
秀 神戸
岸　宏亮
Original Assignee
オリンパス株式会社
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 オリンパス株式会社 filed Critical オリンパス株式会社
Priority to PCT/JP2020/008978 priority Critical patent/WO2021176570A1/fr
Publication of WO2021176570A1 publication Critical patent/WO2021176570A1/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
    • A61B1/005—Flexible endoscopes
    • 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
    • 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

Definitions

  • the present invention relates to an endoscope system and a method of operating an endoscope.
  • an endoscope inserts an insertion part into a subject such as a patient to acquire image data in the subject by an imaging device and to perform treatment with a treatment tool or the like.
  • the curved portion of the insertion portion of the endoscope is configured by connecting a plurality of curved pieces and the like, and a curved tube that can be bent by operating a wire arranged on the inner surface of the curved piece is provided to bend the curved tube. It is possible to change the field of view and insert it according to the curved shape of the subject.
  • Endoscopes with different curved diameters are used according to the intended use.
  • an endoscope having a large curved diameter is preferable for inserting a large intestine or the like having a large curved portion, and for treating lesions.
  • An endoscope with a small bending diameter is preferably used.
  • endoscopes with different curvature diameters after inserting the endoscope to the observation site, the endoscope is pulled out from the body, and the endoscope with a curvature diameter preferable for treatment is reinserted for treatment. (See, for example, Patent Document 1).
  • Japanese Unexamined Patent Publication No. 2010-220951 Japanese Unexamined Patent Publication No. 2003-284671 Japanese Unexamined Patent Publication No. 8-24208
  • the present invention has been made in view of the above, and an object of the present invention is to provide an endoscope system having excellent insertability and therapeutic ability and a method of operating the endoscope.
  • the endoscope system has an imaging unit, a curved member having a curved portion on the tip side, and a channel into which the curved member can be inserted and removed. It is equipped with an endoscope body.
  • an endoscope system having excellent insertability and therapeutic ability, and endoscopy. It becomes possible to provide a method of operating a mirror.
  • FIG. 1 is a diagram schematically showing an overall configuration of an endoscope system according to a first embodiment of the present invention.
  • FIG. 2 is a schematic view showing the configuration of an endoscope.
  • FIG. 3 is an enlarged schematic view of the first curved member.
  • FIG. 4 is a cross-sectional view of the insertion portion of the endoscope.
  • FIG. 5 is a front view of the tip of the endoscope.
  • FIG. 6 is a schematic view illustrating a method of operating the endoscope.
  • FIG. 7A is a schematic view illustrating a bending operation of the tip of the endoscope when the first bending member is inserted.
  • FIG. 7B is a schematic view illustrating a bending operation of the tip of the endoscope when the second bending member is inserted.
  • FIG. 7A is a schematic view illustrating a bending operation of the tip of the endoscope when the first bending member is inserted.
  • FIG. 7B is a schematic view illustrating
  • FIG. 8A is a schematic view illustrating an example of a suitable treatment with an endoscope when the second curved member is inserted.
  • FIG. 8B is a schematic view illustrating an example of a suitable treatment with an endoscope when the second curved member is inserted.
  • FIG. 9 is a schematic view illustrating a procedure using an endoscope according to a second embodiment of the present invention.
  • a mode for carrying out the present invention
  • the present invention is not limited to this embodiment.
  • each of the figures referred to in the following description merely schematically shows the shape, size, and positional relationship to the extent that the contents of the present invention can be understood. That is, the present invention is not limited to the shape, size, and positional relationship exemplified in each figure.
  • FIG. 1 is a diagram schematically showing the overall configuration of the endoscope system 100 according to the first embodiment of the present invention.
  • the endoscope system 1 includes an endoscope 2 that is introduced into a subject and images the inside of the subject to generate an image signal in the subject.
  • Information processing includes an information processing device 3 that performs predetermined image processing on the image signal captured by the endoscope 2 and controls each part of the endoscope system 1, a light source device 4 that generates illumination light of the endoscope 2, and information processing. It includes a display device 5 that displays an image signal after image processing by the device 3, and a fluid control device 9 that performs air supply and water supply suction.
  • the endoscope 2 has an insertion portion 6 to be inserted into the subject, an operation portion 7 on the base end side of the insertion portion 6 and gripped by the operator, and a flexible universal extending from the operation portion 7. It is composed of code 8.
  • the insertion portion 6 is realized by using a light guide made of an illumination fiber, an electric cable, an optical fiber, or the like.
  • the insertion portion 6 has a hard tip portion 6a, a bendable cover curved portion 6b, and a flexible flexible portion 6c provided on the base end side of the cover curved portion 6b.
  • the tip portion 6a includes a pair of illumination units that illuminate the inside of the subject via an illumination lens, an image pickup device 64 that images the inside of the subject, a treatment tool channel 74, an air supply / water supply channel 76, and a first described later.
  • a bending member channel 77 for inserting and removing the bending member (first endoscope driving unit) 10 and the second bending member (second endoscope driving unit) 20 is provided (see FIGS. 4 and 5). ).
  • a bending knob 7a that bends the first bending member 10 and the second bending member 20 described later in the vertical and horizontal directions, and a treatment tool such as a biological forceps and a laser scalpel are inserted into the body cavity of the subject.
  • the treatment tool insertion unit 7b, the plurality of switch units 7c for operating peripheral devices such as the information processing device 3, the light source device 4, and the fluid control device 9, the first bending member 10, and the second bending member 20 It has a curved member insertion portion 7d to be inserted.
  • the treatment tool inserted from the treatment tool insertion portion 7b is exposed from the opening 66 at the tip of the insertion portion 6 via the treatment tool channel provided inside (see FIG. 4).
  • the universal cord 8 is configured by using a light guide made of a lighting fiber, a cable, or the like.
  • the universal cord 8 is branched at the base end, one of the branched ends is the connector 8a, and the other base end is the connector 8b.
  • the connector 8a is detachable from the connector of the information processing device 3.
  • the connector 8a is removable from the light source device 4.
  • the universal cord 8 propagates the illumination light emitted from the light source device 4 to the tip portion 6a via the light guide composed of the connector 8b and the illumination fiber. Further, the universal code 8 transmits the image signal captured by the imaging device to the information processing device 3 via the cable and the connector 8a.
  • the information processing device 3 performs predetermined image processing on the image signal output from the connector 8a and controls the entire endoscope system 1.
  • the light source device 4 is configured by using a light source that emits light, a condenser lens, or the like.
  • the light source device 4 emits light from the light source under the control of the information processing device 3, and is a subject to the endoscope 2 connected via a light guide composed of a connector 8b and an illumination fiber of a universal cord 8. It is supplied as illumination light to the inside of the subject.
  • the display device 5 is configured by using a liquid crystal display, a display display using organic EL (Electro Luminescence), or the like.
  • the display device 5 displays various information including an image that has been subjected to predetermined image processing by the information processing device 3 via the video cable 5a. As a result, the operator can observe the desired position in the subject and determine the symptom by operating the endoscope 2 while looking at the image (internal image) displayed by the display device 5.
  • FIG. 2 is a schematic view showing the configuration of the endoscope 2.
  • the endoscope 2 includes an endoscope main body 2a, a first curved member 10, and a second curved member 20.
  • the endoscope main body 2a includes an image pickup device 64, an illumination unit, a treatment tool channel 74, an air supply / water supply channel 76, and a bending member channel 77, and the bending member channel 77 has a first curvature.
  • the member 10 and the second curved member 20 are inserted and removed.
  • the first bending member 10 has a bending portion 11 that is bendable and a flexible portion 12 that is connected to the base end side of the bending portion 11.
  • the second bending member 20 has a bending portion 21 that is bendable and a flexible portion 22 that is connected to the proximal end side of the bending portion 21.
  • the bending diameter of the bending portion 11 of the first bending member 10 is larger than the bending diameter of the bending portion 21 of the second bending member 20.
  • FIG. 3 is an enlarged schematic view of the first curved member 10.
  • a plurality of curved pieces 13 are connected to each other, and wires 14 are inserted in the upper, lower, left and right sides of the connected curved pieces 13.
  • the flexible portion 12 is composed of a tube with a flexible lumen 15, and a wire 14 is inserted into the lumen 15.
  • the second curved member 20 has the same configuration as the first curved member 10, but the length r1 of the curved portion of the first curved member 10 is longer than the length of the curved portion 21 of the second curved member. As a result, the bending diameter becomes large.
  • FIG. 4 is a cross-sectional view of the insertion portion 6 of the endoscope 2.
  • the tip portion 6a of the tip portion 6a located on the tip end side of the insertion portion 6 of the endoscope 2 is fitted with the tip portion 6a by the tip cover 61.
  • the tip cover 61 is provided with an observation window 63, an illumination window 75 of the illumination unit (see FIG. 5), an opening for air supply / water supply, and an opening 66 forming a treatment tool channel 74.
  • An imaging device 64 for imaging the inside of the subject is inserted in the proximal end side of the observation window 63.
  • an air supply / water supply hole, a treatment tool channel 74, and the like are provided so as to correspond to an opening for air supply / water supply and an opening 66 constituting the treatment tool channel 74, respectively.
  • the tip block 62 is arranged.
  • the tip block 62 is also provided with a curved member insertion hole 65.
  • a treatment tool insertion pipe 68 is provided at the rear end of the treatment tool channel 74 in the tip block 62, and the treatment tool insertion tube 70 is connected to the treatment tool insertion pipe 68.
  • a curved member insertion pipe 67 is provided at the rear end of the curved member insertion hole 65, and the curved member insertion tube 69 is connected to the curved member insertion pipe 67.
  • the treatment tool channel 74 including the opening 66, the treatment tool insertion pipe 68, and the treatment tool insertion tube 70 is a channel that opens at both ends, and is composed of a curved member insertion hole 65, a curved member insertion pipe 67, and a curved member insertion tube 69.
  • the curved member channel 77 is a channel that opens on the proximal end side and does not open on the distal end side.
  • FIG. 5 is a front view of the tip portion 6a of the endoscope 2.
  • the curved member channel 77 is arranged at the center of the insertion portion 6 of the endoscope main body 2a in the axial direction, and the imaging device 64 (observation window) is arranged around the curved member channel 77.
  • an illumination unit illumination window 75
  • a treatment tool channel 74 treatment tool channel 74
  • an air supply / water supply channel 76 are provided.
  • FIG. 6 is a schematic view for explaining the operation method of the endoscope 2, and a case where the large intestine lb is treated with an endoscope will be described as an example.
  • the first bending member 10 for example, a member having a curved portion 11 having a length of about 135 mm is used, and for the second bending member 20, for example, a member having a bending portion 21 having a length of about 55 mm is used. used.
  • An endoscope having a curved portion having a length of about 135 mm is conventionally used for large intestine observation, and an endoscope having a curved portion having a length of about 55 mm is used for endoscopic submucosal peeling. It is used for.
  • the first bending member 10 having a long bending length of the bending portion 11 is inserted into the bending member channel 77 of the insertion portion 6 of the endoscope 2, and FIG. 6B ),
  • the insertion portion 6 into which the first bending member 10 is inserted is inserted into the large intestine lb.
  • the curved portion 11 of the first bending member 10 is curved so as to follow the shape of the large intestine lb, and is inserted while performing advancing / retreating and twisting operations integrally with the endoscope main body 2a. ..
  • the cover curved portion 6b is also formed by inserting the first curved member 10 having a curved diameter close to the diameter of the curved portion of the large intestine and bending the curved portion 11. It is curved in the same manner as the curved portion 11, and the insertion portion 6 can be easily inserted.
  • the observation diagnosis of the lesion P is performed.
  • the first bending member 10 is pulled out from the bending member channel 77 of the insertion portion 6 (see FIG. 6D).
  • the second bending member 20 having a short bending length of the bending portion 11 is connected to the bending member channel 77 of the insertion portion 6. Is inserted (see FIG. 6 (f)).
  • the tip portion 6a of the insertion portion 6 is located in the vicinity of the lesion P, and the lesion is observed by the imaging device 64. , There is no risk of losing sight of lesion P.
  • the bending operation of the bending portion 21 of the second bending member 20 is performed to bring the treatment tool closer to the lesion P.
  • Treatment of lesion P with a treatment tool for example, local injection, peri-incision, incision detachment, suturing and the like.
  • a treatment tool for example, local injection, peri-incision, incision detachment, suturing and the like.
  • the lumen diameter of the large intestine lb is as narrow as about 60 mm on average. It becomes difficult to approach the lesion P with the tip 6a.
  • the second curved member 20 having a short curved length is used, as shown in FIG.
  • the curved portion 21 is curved until the tip portion 6a is inverted to treat the lesion P, or as shown in FIG. 8 (b), the lesion P is the back of the fold.
  • the use of the second curved member 20 having a short curved length facilitates the approach to the lesion P and facilitates the treatment. If it is difficult to approach the lesion P even with the second curved member 20 having a short curved length, a third curved member having a shorter curved length or an intermediate between the first curved member 10 and the second curved member 20.
  • the treatment may be performed using a fourth curved member having a curved length of.
  • the insertion portion 6 of the endoscope 2 is removed from the subject together with the second curved member 20 (see FIG. 6 (h)).
  • the second bending member 20 is pulled out from the bending member channel 77.
  • the endoscope main body 2a is discarded, and the first curved member 10 and the second curved member 20 can be reused in the next procedure after cleaning.
  • the long-curved first curved member 10 is used for insertion, the short-curved second curved member 20 is inserted into the curved member channel 77 for treatment, and the cover curvature of the insertion portion 6 is performed.
  • the portion 6b By bending the portion 6b, it is possible to provide the endoscope 2 having an excellent balance between insertability and therapeutic property.
  • the risk of infection is reduced by making the endoscope body 2a that comes into contact with the subject disposable and reusing the first curved member 10 and the second curved member 20 that can be inserted into and removed from the endoscope body 2a. At the same time, it is possible to suppress an increase in cost.
  • the lesion P is observed by the imaging device 64 when the first curved member 10 is inserted and removed, it is easy to approach the lesion P after the insertion of the second curved member 20. Become.
  • the lesion P is constantly observed, it is possible to quickly respond to unexpected bleeding or the like.
  • the image pickup apparatus 64 is fixed to the endoscope main body 2a and is discarded together with the endoscope main body 2a after the operation, but is reused as being removable from the endoscope main body 2a. May be good.
  • FIG. 9 is a schematic view illustrating a procedure using an endoscope according to a second embodiment of the present invention, and a case where the stomach S is treated with an endoscope will be described as an example.
  • the first bending member 10 for example, a member having a curved portion 11 having a length of about 70 mm is used
  • the second bending member 20 for example, a member having a bending portion 21 having a length of about 105 mm is used. used.
  • the first bending member 10 having a short bending length of the bending portion 11 is inserted into the bending member channel 77 of the insertion portion 6 of the endoscope 2, and the first bending member 10 is inserted into the insertion.
  • Part 6 is inserted into the stomach S.
  • an observation diagnosis of the lesion P is performed, and after the observation diagnosis, the first curved member 10 is pulled out from the insertion portion 6.
  • the second bending member 20 having a long bending length of the bending portion 11 is inserted into the bending member channel 77 of the insertion portion 6 of the endoscope 2.
  • the curved portion 21 of the second curved member 20 is curved to treat the lesion P with the treatment tool.
  • the insertion portion 6 into which the second bending member 20 having a long bending length shown by the dotted line is inserted has the first one having a shorter bending length shown by the solid line.
  • the approach to the lesion P in the tangential direction of the stomach wall becomes easier than that of the curved member 10.
  • the endoscope system and the method of operating the endoscope according to the present invention can be suitably used for an endoscope having excellent insertability and therapeutic property.

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

Abstract

L'invention concerne un système d'endoscope ayant une excellente aptitude à l'insertion et des propriétés thérapeutiques excellentes, et un procédé pour faire fonctionner un endoscope. Ce système d'endoscope comprend un corps d'endoscope comprenant : une unité de capture d'image ; un élément de courbure ayant une partie de courbure sur le côté d'extrémité distale ; et un canal à travers lequel l'élément de courbure peut être inséré et retiré.
PCT/JP2020/008978 2020-03-03 2020-03-03 Système d'endoscope et procédé pour faire fonctionner un endoscope WO2021176570A1 (fr)

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PCT/JP2020/008978 WO2021176570A1 (fr) 2020-03-03 2020-03-03 Système d'endoscope et procédé pour faire fonctionner un endoscope

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20220304552A1 (en) * 2021-03-29 2022-09-29 Fujifilm Corporation Endoscope

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPS6321066A (ja) * 1986-07-16 1988-01-28 オリンパス光学工業株式会社 医療用チユ−ブ
JPH0666606U (ja) * 1993-02-26 1994-09-20 オリンパス光学工業株式会社 チャンネル付き内視鏡カバー方式の内視鏡
JPH07116106A (ja) * 1993-10-22 1995-05-09 Olympus Optical Co Ltd カバー式内視鏡
JP2005279125A (ja) * 2004-03-31 2005-10-13 Pentax Corp 電子内視鏡の先端部
JP2010220951A (ja) * 2009-03-25 2010-10-07 Olympus Medical Systems Corp カバー式処置内視鏡及び内視鏡カバー

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPS6321066A (ja) * 1986-07-16 1988-01-28 オリンパス光学工業株式会社 医療用チユ−ブ
JPH0666606U (ja) * 1993-02-26 1994-09-20 オリンパス光学工業株式会社 チャンネル付き内視鏡カバー方式の内視鏡
JPH07116106A (ja) * 1993-10-22 1995-05-09 Olympus Optical Co Ltd カバー式内視鏡
JP2005279125A (ja) * 2004-03-31 2005-10-13 Pentax Corp 電子内視鏡の先端部
JP2010220951A (ja) * 2009-03-25 2010-10-07 Olympus Medical Systems Corp カバー式処置内視鏡及び内視鏡カバー

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20220304552A1 (en) * 2021-03-29 2022-09-29 Fujifilm Corporation Endoscope

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