WO2022172321A1 - 内視鏡 - Google Patents
内視鏡 Download PDFInfo
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- WO2022172321A1 WO2022172321A1 PCT/JP2021/004757 JP2021004757W WO2022172321A1 WO 2022172321 A1 WO2022172321 A1 WO 2022172321A1 JP 2021004757 W JP2021004757 W JP 2021004757W WO 2022172321 A1 WO2022172321 A1 WO 2022172321A1
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- Prior art keywords
- shaft
- channel
- camera
- tip
- diameter
- Prior art date
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- 238000003384 imaging method Methods 0.000 claims abstract description 5
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- 210000000013 bile duct Anatomy 0.000 claims description 9
- 210000000277 pancreatic duct Anatomy 0.000 claims description 9
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- 230000002183 duodenal effect Effects 0.000 description 2
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Images
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
- A61B1/018—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/012—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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00064—Constructional details of the endoscope body
- A61B1/00066—Proximal part of endoscope body, e.g. handles
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- A—HUMAN NECESSITIES
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- A61B1/00064—Constructional details of the endoscope body
- A61B1/00071—Insertion part of the endoscope body
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- A—HUMAN NECESSITIES
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- 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
- A61B1/0011—Manufacturing of endoscope parts
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/005—Flexible endoscopes
- A61B1/0051—Flexible endoscopes with controlled bending of insertion part
- A61B1/0055—Constructional details of insertion parts, e.g. vertebral elements
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- A61B1/005—Flexible endoscopes
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- A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
- A61B1/042—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances characterised by a proximal camera, e.g. a CCD camera
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
- A61B1/05—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances characterised by the image sensor, e.g. camera, being in the distal end portion
- A61B1/051—Details of CCD assembly
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- A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
- A61B1/05—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances characterised by the image sensor, e.g. camera, being in the distal end portion
- A61B1/053—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances characterised by the image sensor, e.g. camera, being in the distal end portion being detachable
Definitions
- the present invention relates to an endoscope, and more particularly to an endoscope equipped with a shaft to be inserted into the body, a handle for operation, and a camera.
- an endoscope equipped with a shaft to be inserted into the body, a handle for operation, and a camera is known as a small endoscope used for diagnosis and treatment of bile ducts and pancreatic ducts through a duodenal endoscope. (See Patent Document 1 below).
- a camera An optical assembly 40 is positioned to form a forceps channel (working channel 60) and a channel used for perfusion/aspiration etc. (additional channel 62).
- the outer diameter of the shaft that constitutes the endoscope is about 5 to 12 Fr (1.67 to 4 mm), and the forceps channel (actuating channel 60) formed therein is used as a "recovery basket device or bioreactor.” "of sufficient diameter to accept actuators up to 4 Fr, such as an inspection forceps.”
- Small endoscopes used for diagnostic treatment of bile ducts, pancreatic ducts, and the like have shafts with small outer diameters.
- the outer diameter of the biological forceps that can be inserted into the forceps channel formed in the shaft is 4 Fr (1.33 mm) or less.
- Such small-diameter biological forceps are much more expensive than general-purpose forceps with an outer diameter of about 1.75 to 1.85 mm. There is a problem that good clinical results cannot be obtained because sometimes sufficient tissue cannot be collected.
- the small-diameter shaft that constitutes the endoscope has a channel for arranging a camera, a water supply channel, and a wire lumen for inserting an operation wire for deflecting the tip of the shaft. Therefore, the ratio of the resin constituting the shaft is low, and the shaft does not have sufficient rigidity, and kinks and the like are likely to occur at the tip flexible portion of the shaft. If a kink occurs in the tip flexible portion, there is a risk that the optical fiber arranged inside the shaft will break.
- An object of the present invention is to provide a small-sized endoscope that can be used for diagnosis and treatment of bile ducts, pancreatic ducts, and the like, while allowing the use of general-purpose biological forceps.
- Another object of the present invention is to provide an endoscope in which a kink is unlikely to occur at the distal end flexible portion of the shaft and an optical fiber constituting a light guide mechanism is not broken.
- the endoscope of the present invention comprises a resin shaft having a distal flexible portion and having a camera channel and a forceps channel formed therein; a handle attached to the proximal end of the shaft; a camera having a camera head having an imaging element mounted thereon and a cable tube, and being detachably arranged with respect to the shaft and the handle by being inserted through the inside of the camera channel and the handle.
- central axes of the camera channel and the forceps channel are located on the same plane including the central axis of the shaft;
- the outer diameter (D) of the shaft is 2.8 to 4.1 mm;
- the diameter (d1) of the camera channel is 0.75 to 1.2 mm; (D ⁇ d1) is 1.95 to 3.25 mm.
- the shaft since the outer diameter (D) of the shaft is 2.8 to 4.1 mm, the shaft can be inserted into a bile duct, a pancreatic duct, or the like, and used for diagnosis and treatment in the duct. can be used. Further, since the difference (D ⁇ d1) between the outer diameter (D) of the shaft and the diameter (d1) of the camera channel is 1.95 to 3.25 mm, the forceps channel through which a commonly used biological forceps can be inserted. can be formed on the shaft.
- the diameter (d1) of the camera channel is 0.75 to 1.1 mm, which is smaller than that of conventional endoscopes, it is possible to secure a certain proportion of the resin that constitutes the shaft. It is possible to prevent the kink from occurring in the tip flexible portion of the shaft.
- the forceps channel has a diameter (d2) of 1.8 to 3.1 mm.
- a general-purpose biological forceps having an outer diameter of about 1.75 mm can be inserted.
- the forceps channel has a diameter (d2) of 1.9 to 2.1 mm.
- a general-purpose biological forceps having an outer diameter of about 1.85 mm can be inserted.
- the camera has a light guide mechanism including an optical fiber.
- the endoscope having such a configuration it is not necessary to separately form a channel for arranging the optical fiber, and it is possible to sufficiently reduce the diameter of the shaft and the size of the device.
- the camera that constitutes the endoscope of the present invention is detachably attached to the shaft (not fixed to the shaft), when the distal end flexible portion of the shaft is bent, the camera channel is bent. By moving the camera in the axial direction, the load on the optical fiber located inside the camera can be relieved.
- the ratio of the total area of all channels or lumens including the camera channel and the forceps channel to the area of the shaft is 65% or less ( It is preferable that the ratio of the resin constituting the shaft is 35% or more).
- the endoscope having such a configuration, it is possible to ensure the rigidity (bending rigidity) of the shaft to some extent, so that it is possible to effectively prevent kinks at the distal flexible portion.
- the rigidity of the shaft at the semicircular portion where the camera (optical fiber) is located can be increased to prevent kinking, so that the distal end flexible portion of the shaft can be It is possible to reliably prevent disconnection of the optical fiber when it is bent.
- the shaft has two water supply channels having a diameter (d3) of 0.4 to 1.0 mm and a diameter of 0.2 to 0.5 mm.
- Four wire lumens having a diameter (d4) are formed, and an operation wire whose rear end can be pulled is extended in each of the wire lumens, and by pulling the rear end,
- the tip of the shaft is configured to deflect.
- the handle provided on the proximal end side of the shaft and provided with a rotation operation section; Disposed on the distal end side of the shaft, has substantially the same outer diameter as the shaft, communicates with each of the camera channel, the forceps channel and the water supply channel of the shaft and opens at the distal end surface thereof.
- a resin tip in which a camera channel, a forceps channel and a water channel are formed; each of the camera channel, the forceps channel and the water channel of the shaft;
- a main through hole formed so as to surround all of the communication paths, and a wire lumen formation position a metallic or ceramic intermediate member having four correspondingly formed secondary through-holes; Having a tip large-diameter portion embedded in the distal tip and having a diameter larger than the diameter of the secondary through-hole of the intermediate member, passing through each of the secondary through-holes to each of the wire lumens of the shaft It is preferable to have the four extending operating wires.
- the intermediate member disposed between the resin shaft and the resin distal tip can reliably fix the distal end of the operation wire to the distal end of the shaft. can. That is, when the rear end of the operation wire is pulled, the large-diameter portion of the distal end is caught in the secondary through-hole of the intermediate member, so that the distal end of the operation wire can be restricted from moving in the proximal direction. As a result, the tip flexible portion of the shaft can be reliably bent.
- the intermediate member disperses the pressing force in the proximal direction against the distal end surface of the shaft by the large-diameter tip portion (relieves the concentration of the pressing force). As a result, it is possible to more effectively prevent kink from occurring in the distal flexible portion even if the ratio of the resin constituting the shaft is not high.
- the endoscope of the present invention is preferably used as a child endoscope inserted through the forceps lumen of a side scope such as a duodenal endoscope.
- the endoscope of the present invention is preferably used for diagnosing and treating diseases in the bile duct or pancreatic duct.
- the endoscope of the present invention although it is a small endoscope having a shaft with an outer diameter of 2.8 to 4.1 mm, it uses general-purpose biological forceps that could not be used with conventional small-diameter endoscopes. can do. In addition, kink is less likely to occur in the flexible portion at the distal end of the shaft, and breakage of the optical fiber constituting the light guide mechanism can be prevented.
- FIG. 1 is an explanatory diagram showing the appearance of an embodiment of an endoscope of the present invention
- FIG. 2 is a partially enlarged view (detailed view of part II) showing the distal end portion of the endoscope shown in FIG. 1
- FIG. 3 is a view taken along line IIIA-IIIA of FIG. 2
- FIG. 3 is a cross-sectional view (cross-sectional view of the shaft) along IIIB-IIIB in FIG. 2
- FIG. 3 is a cross-sectional view taken along IIIC-IIIC in FIG. 2 (a cross-sectional view of the distal tip);
- FIG. 3 is a cross-sectional view along IIID-IIID in FIG.
- FIG. 2 is a perspective view showing the distal end portion (illustration of a camera is omitted) of the endoscope shown in FIG. 1;
- FIG. 2 is a perspective view showing the distal end portion (illustration of a camera is omitted) of the endoscope shown in FIG. 1;
- FIG. 1 is a perspective view showing the distal end portion (illustration of a camera is omitted) of the endoscope shown in FIG. 1;
- FIG. 2 is a cross-sectional view showing a state in which a slide member of a camera connector that constitutes the endoscope shown in FIG. 1 is at a proximal end position;
- FIG. 2 is a cross-sectional view showing a state in which a slide member of a camera connector that constitutes the endoscope shown in FIG. 1 is at a distal end position;
- FIG. 2 is a perspective view showing a state in which the distal end of a camera that constitutes the endoscope shown in FIG. 1 is located at a first position on the proximal side with respect to the distal end surface of the distal tip.
- FIG. 2 is a perspective view showing a state in which the distal end of a camera that constitutes the endoscope shown in FIG. 1 is located at a second position on the distal side with respect to the distal end face of the distal tip.
- FIGS. 1-8 FIGS. 8A and 8B
- This endoscope 100 has a distal flexible portion 10A, a camera channel 13, two water supply channels 141, 142 and a forceps channel 17, and four wire lumens 151, 152, 153, 154.
- a formed resin shaft 10 a handle 20 disposed on the proximal end side of the shaft 10 and provided with a rotary operation section (an operation knob 25 and an operation knob 26); It is arranged on the distal side of the shaft 10, has the same outer diameter as the shaft 10, communicates with each of the camera channel 13, the water supply channels 141 and 142, and the forceps channel 17 of the shaft 10, and opens at the distal end surface 35 thereof.
- a resin tip 30 in which a camera channel 33, water channels 341 and 342, and a forceps channel 37 are formed; It is arranged between the shaft 10 and the distal tip 30 and has a disc shape having the same outer diameter as the shaft 10.
- a metallic intermediate member 40 having 4;
- the leading end large diameter portions 511, 521, 531, 541 having diameters larger than the diameters of the secondary through holes 421, 422, 423, 424 of the intermediate member 40 are embedded in the tip 30, and the secondary through holes 421, 422 , 423, 424 to each of the wire lumens 151, 152, 153, 154 of the shaft 10, and the rear end of each of the wire lumens 151, 152, 153, 154 of the shaft 10 is connected to the rotary operation portion (the operation knob 25 or the operation knob 26) of the handle 20.
- the central axes of the camera channel 13 and forceps channel 17 formed in the shaft 10 are located on the same plane including the central axis of the shaft 10, and the outer diameter (D) of the shaft 10 is 2.8 to 4.1 mm.
- the diameter (d1) of the camera channel 13 is 0.75-1.1 mm
- the difference (D ⁇ d1) between the outer diameter of the shaft 10 and the diameter of the camera channel is 1.95-3.25 mm.
- This endoscope 100 includes a shaft 10 to be inserted into the body, a handle 20 arranged on the proximal side of the shaft 10, a distal tip 30 arranged on the distal side of the shaft 10, and the shaft 10 and the distal tip 30. It comprises an intermediate member 40 arranged between, operation wires 51, 52, 53, 54, and a camera 60. - ⁇
- a camera channel 13 As shown in FIGS. 3B, 4A and 6A, a camera channel 13, water supply channels 141 and 142, and a forceps channel 17 are formed in the shaft 10 constituting the endoscope 100. As shown in FIGS. Further, the shaft 10 is formed with wire lumens 151, 152, 153, 154 through which the operation wires 51, 52, 53, 54 are inserted.
- the length (effective length) of the shaft 10 is preferably 200 to 4800 mm, and a preferred example is 1900 mm.
- the shaft 10 has a distal flexible portion 10A.
- the "flexible tip portion” refers to the tip portion of the shaft that can be bent (bent) by pulling the rear end of the operation wire.
- the length of the tip flexible portion 10A is preferably 5 to 200 mm, and a preferred example is 20 mm.
- the outer diameter (D) of the shaft 10 is usually 2.8-4.1 mm, preferably 3.2-3.7 mm, and a preferred example is 3.6 mm.
- Such a small-diameter shaft 10 can be inserted into a bile duct or a pancreatic duct for diagnostic treatment within the duct.
- the diameter (d1) of the camera channel 13 is usually 0.75-1.2 mm, preferably 0.95-1.1 mm, and a preferred example is 1.05 mm.
- the difference (D ⁇ d1) between the outer diameter (D) of the shaft 10 and the diameter (d1) of the camera channel is usually 1.95 to 3.25 mm, preferably 2.05 to 3.18 mm.
- a typical example is 2.3 mm (3.5 mm-1.2 mm).
- the difference (D-d1) between the outer diameter of the shaft (D) and the diameter of the camera channel (d1) is 1.9 Since the diameter is 5 to 3.25 mm, the diameter (d2) of the forceps channel 17 can be set to a size (1.8 mm or more) through which general-purpose biological forceps having an outer diameter of 1.75 mm or more can be inserted. can. If (D ⁇ d1) is less than 1.95 mm, it is impossible or extremely difficult to form a forceps channel through which a general-purpose biological forceps can be inserted. If (D ⁇ d1) exceeds 3.25 mm, it is impossible or extremely difficult to reduce the outer diameter of the shaft to 4.1 mm or less.
- the camera channel has a diameter (d1) of 0.75 to 1.1 mm, which is smaller than that of conventional endoscopes, a certain proportion of the resin constituting the shaft 10 can be ensured. As a result, it is possible to prevent the tip flexible portion 10A of the shaft 10 from being kink. If (d1) is less than 0.75 mm, it is impossible or very difficult to insert the camera. If (d1) exceeds 1.1 mm, it is impossible or extremely difficult to make (D ⁇ d1) 3.25 mm or less.
- the diameter (d2) of the forceps channel 17 is preferably 1.8-3.1 mm, more preferably 1.9-2.1 mm, and a preferred example is 2.0 mm. Since the diameter (d2) of the forceps channel 17 is 1.8 mm or more, it is possible to insert a general-purpose biological forceps having an outer diameter of about 1.75 mm, which cannot be inserted with a conventional endoscope. If the diameter (d2) of the forceps channel 17 is 1.9 mm or more, it is possible to insert general-purpose biological forceps having an outer diameter of about 1.85 mm.
- general-purpose biological forceps By using such general-purpose biological forceps, a sufficient amount of tissue can be collected at the time of biopsy, and favorable clinical results can be obtained.
- general-purpose biomedical forceps are significantly less expensive than forceps with an outer diameter of 4Fr (1.33 mm) or less that can be passed through a conventional endoscope.
- the diameter (d3) of the water supply channels 141, 142 is preferably 0.4 to 1.0 mm, and a preferred example is 0.75 mm.
- the diameter (d4) of the wire lumens 151, 152, 153, 154 is preferably 0.2-0.5 mm, and a preferred example is 0.33 mm.
- the total area of the camera channel 13, forceps channel 17, water supply channels 141, 142, and wire lumens 151, 152, 153, 154 [ ⁇ (d1) 2 /4+ ⁇ (d2 ) 2 /4 + ⁇ (d3) 2 /2 + ⁇ (d4) 2 ] in the area of the shaft [ ⁇ (D) 2 /4] is 65% or less (ratio of resin constituting the shaft is 35% or more). more preferably 50 to 60%, and a preferred example is 55% [(1.1 2 ⁇ /4+2.0 2 ⁇ /4+0.75 2 ⁇ /2+0.33 2 ⁇ )/(3. 5 2 ⁇ /4)].
- the shaft 10 is made of resin.
- the resin material that constitutes the shaft 10 include nylon resin, polyether block amide (PEBAX) resin, polyurethane resin and polyolefin resin, among which PEBAX resin and polyurethane resin are preferred.
- the hardness (Shore D hardness) of the constituent resin of the shaft 10 is preferably 90D or less.
- the hardness of the resin constituting the other portion is set to 30D.
- a handle 20 is arranged on the proximal end side of the shaft 10 .
- a handle 20 that constitutes the endoscope 100 includes a grip 21 and two operation knobs 25 and 26 as rotary operation units.
- the handle 20 is provided with a camera channel port 23 communicating with the camera channel 13 and a forceps channel port 27 communicating with the forceps channel 17 .
- a distal tip 30 is arranged on the distal end side of the shaft 10 .
- the distal tip 30 constituting the endoscope 100 is formed with a camera channel 33, water supply channels 341 and 342, and a forceps channel 37.
- FIGS. 3A, 3C and 6B the distal tip 30 constituting the endoscope 100 is formed with a camera channel 33, water supply channels 341 and 342, and a forceps channel 37.
- the camera channel 33 communicates with the camera channel 13 of the shaft 10 via a communication passage 43. As shown in FIG. The diameter of camera channel 33 is the same as the diameter of camera channel 13 communicating therewith.
- the water channels 341 and 342 communicate with the water channels 141 and 142 of the shaft 10 via communication paths 441 and 442, respectively.
- the water channels 341, 342 have the same diameter as the water channels 141, 142 communicating therewith.
- Forceps channel 37 communicates with forceps channel 17 of shaft 10 via communication passage 47 .
- the diameter of the forceps channel 37 is the same as the diameter of the forceps channel 17 communicating therewith.
- the length of the distal tip 30 is preferably 1 to 30 mm, and a preferred example is 3 mm.
- the distal tip 30 has the same outer diameter as the shaft 10 .
- the tip 30 is made of resin.
- the resin material forming the distal tip 30 the same resins as those exemplified as the resin forming the shaft 10 can be used. Among them, the PEBAX resin and the polyurethane resin are preferable.
- the distal tip 30 is made of a low-hardness resin material so as not to damage body tissues.
- the hardness (Shore D hardness) of the constituent resin of the distal tip 30 is preferably 72D or less, and a preferred example is 25D.
- a disk-shaped intermediate member 40 is arranged between the shaft 10 and the distal tip 30 .
- the intermediate member 40 constituting the endoscope 100 is a member for fixing the tip of each of the operation wires 51, 52, 53, 54 to the tip of the shaft 10 (preventing the tip from coming off when the rear end is pulled). .
- the intermediate member 40 is formed with one main through-hole 41 surrounding all of the communication passage 43 and the communication passages 441, 442 and 47. As shown in FIGS. 3D and 6B, the intermediate member 40 is formed with one main through-hole 41 surrounding all of the communication passage 43 and the communication passages 441, 442 and 47. As shown in FIGS. 3D and 6B, the intermediate member 40 is formed with one main through-hole 41 surrounding all of the communication passage 43 and the communication passages 441, 442 and 47. As shown in FIGS.
- the communication path 43 is a path (camera channel), and the diameter of the communicating path 43 is the same as that of the camera channel 13 and the camera channel 33 .
- the communicating passages 441 and 442 are formed by the resin 130 of the shaft 10 and/or the distal tip 30 in order to communicate the respective water feeding channels 141 and 142 of the shaft 10 with the respective water feeding channels 341 and 342 of the distal tip 30. These are partitioned passages (water supply channels), and the diameters of the communication paths 441 and 442 are the same as the diameters of the water supply channels 141 and 142 and the water supply channels 341 and 342 .
- the communication passage 47 is a passage (forceps channel) defined by the constituent resin 130 of the shaft 10 and/or the distal tip 30 in order to communicate the forceps channel 17 of the shaft 10 and the forceps channel 37 of the distal tip 30 .
- the diameter of the communicating passage 47 is the same as the diameters of the forceps channel 17 and the forceps channel 37 .
- the intermediate member 40 is formed with four secondary through holes 421 , 422 , 423 , 424 corresponding to the formation positions of the wire lumens 151 , 152 , 153 , 154 of the shaft 10 .
- the secondary through holes 421 , 422 , 423 , 424 serve as passages for the operation wires 51 , 52 , 53 , 54 .
- the secondary through-holes 421, 422, 423, 424 are circular holes, and their diameters are larger than the diameters of the operation wires 51, 52, 53, 54 to be inserted. , 521, 531, 541.
- the diameter of the secondary through hole is preferably 0.13 to 2.5 mm, and a preferred example is 0.35 mm.
- the thickness of the intermediate member 40 is preferably 0.05 to 3 mm, and a preferred example is 0.15 mm. If the thickness of the intermediate member 40 is too small, there is a risk that the intermediate member 40 will be damaged due to the mechanical impact that accompanies the pulling operation of the operating wires 51, 52, 53, . On the other hand, if the thickness is excessively large, the intermediate member 40 itself is difficult to bend, so there is a possibility that the tip flexible portion 10A may be difficult to bend.
- the outer diameter of the intermediate member 40 is the same as the outer diameters of the shaft 10 and the distal tip 30, so that the outer peripheral surface of the shaft 10, the outer peripheral surface of the intermediate member 40, and the outer peripheral surface of the distal tip 30 are flush with each other. Intermediate member 40 does not protrude from between 10 and distal tip 30 to expose its edge, and such edge does not damage internal tissue.
- the intermediate member 40 is made of metal or ceramics, preferably made of metal.
- the metal material forming the intermediate member 40 include stainless copper, platinum, gold, copper, nickel, titanium, tantalum, etc. Among them, stainless copper is preferable.
- the endoscope 100 of the present embodiment the area inside the main through hole 41 of the intermediate member 40 and outside each of the communicating paths 43, 441, 442, 47 (main through hole 41 excluding the communicating path) ), the shaft 10 and the distal tip 30 are directly joined (the resins constituting the two are welded together). Thereby, the intermediate member 40 is also fixed by the resin inside the main through hole 41 , and the intermediate member 40 is firmly fixed to the shaft 10 and the tip 30 . Moreover, since the shaft 10 and the distal tip 30 are directly joined, although partially, the fixing force of the distal tip 30 to the shaft 10 is sufficiently high.
- (S) be the area of the region where the constituent resin of the shaft 10 and the tip 30 are directly bonded
- (S 0 ) be the cross-sectional area of the shaft 10, then (S)/(S 0 ).
- the value is preferably 0.1 or more, more preferably 0.3 to 0.6.
- operation wires 51, 52, 53, and 54 extend through wire lumens 151, 152, 153, and 154 of shaft 10, respectively.
- the distal ends of the operation wires 51, 52, 53, and 54 are distal large-diameter portions 511, 521, 531, and 541, respectively.
- the tip large-diameter portions 511 , 521 , 531 , 541 are spherical or partially spherical with diameters larger than the diameters of the secondary through holes 421 , 422 , 423 , 424 of the intermediate member 40 . , 424 cannot be traversed.
- the diameter of the tip large diameter portions 511, 521, 531, 541 is preferably 0.2 to 3.5 mm, and a preferred example is 0.4 mm.
- the diameter of the operation wires 51, 52, 53, 54 (parts other than the tip large diameter portion) is preferably 0.1 to 2.0 mm, and a preferred example is 0.25 mm.
- the operation wires 51 and 52 are held in a state in which their distal large-diameter portions 511 and 521 are embedded in the distal tip 30 , and the wire portions on the proximal side of the distal large-diameter portions 511 and 521 are attached to the intermediate member 40 . It extends to the wire lumens 151 and 152 of the shaft 10 through the secondary through holes 421 and 422 . Base ends of the operation wires 51 and 52 are fixed to the operation knob 25 of the handle 20, respectively.
- the operation wire 51 moves in the wire lumen 151 in the proximal direction.
- the tip large-diameter portion 511 is caught in the secondary through-hole 421 of the intermediate member 40 and restricted from moving in the proximal direction. and the distal end of the endoscope 100 (distal tip 30) deflects in the same direction.
- the operation wire 52 moves in the wire lumen 152 in the proximal direction.
- the tip large-diameter portion 521 is caught in the secondary through-hole 422 of the intermediate member 40 and is restricted from moving in the proximal direction, so that the tip flexible portion 10A of the shaft 10 moves in the direction indicated by the arrow A2 in FIG. 3A. and the distal end of the endoscope 100 (distal tip 30) deflects in the same direction.
- the operation wires 53 and 54 are held in a state in which their distal large-diameter portions 531 and 541 are embedded in the distal tip 30 , and the wire portions on the proximal side of the distal large-diameter portions 531 and 541 are attached to the intermediate member 40 .
- the wire lumens 153, 154 of the shaft 10 pass through the secondary through holes 423, 424. extends to Base ends of the operation wires 53 and 54 are fixed to the operation knob 26 of the handle 20, respectively.
- the operation wire 53 moves in the wire lumen 153 in the proximal direction.
- the tip large-diameter portion 531 is caught in the secondary through-hole 423 of the intermediate member 40 and restricted from moving in the proximal direction. and the distal end of the endoscope 100 (distal tip 30) deflects in the same direction.
- the operation wire 54 moves in the wire lumen 154 in the proximal direction.
- the tip large-diameter portion 541 is caught in the secondary through-hole 424 of the intermediate member 40 and restricted from moving in the proximal direction. and the distal end of the endoscope 100 (distal tip 30) deflects in the same direction.
- the tip large-diameter portions 511 , 521 , 531 , 541 extend through the secondary through holes 421 , 422 , 422 , 422 formed in the intermediate member 40 . 423, 424 and the distal ends of the operation wires 51, 52, 53, 54 are fixed (retained) to the distal end of the shaft 10, thereby moving the distal flexible portion 10A of the shaft 10 in the desired direction. (directions indicated by arrows A1 to A4).
- the distal end of the operating wire (tip large-diameter portion) is sufficiently pulled against the distal end of the shaft when the proximal end of the operating wire is pulled. It cannot be fixed (retained), and the distal large-diameter portion may move in the proximal direction while expanding the wire lumen, in which case the distal flexible portion cannot be deflected.
- the material constituting the operation wires 51, 52, 53, 54 is not particularly limited, and the same material as the material constituting the operation wires used in conventionally known medical devices for tip deflection operation is used. be able to.
- a camera 60 that constitutes the endoscope 100 is composed of a camera head 61 on which a CMOS image sensor 611 is mounted, and a cable tube 62 that includes a transmission cable for the CMOS image sensor 611 .
- the camera 60 incorporates a plurality of (24 in the illustrated example) optical fibers 65 surrounding a CMOS image sensor 611 .
- the diameter of the shaft 10 can be reduced and the size of the device can be sufficiently reduced.
- the camera 60 constituting the endoscope 100 is detachably attached to the shaft 10 (not fixed to the shaft 10), when the distal end flexible portion 10A of the shaft 10 is bent, The axial movement of the camera 60 within the camera channel 13 relieves the load on the optical fiber 65 located inside the camera 60 .
- the outer diameter of the camera head 61 is preferably 0.7 to 1.0 mm, and a preferred example is 1.0 mm.
- the cable tube 62 has substantially the same outer diameter as the camera head 61 .
- Camera 60 is positioned in camera channels (camera channel 13 and camera channel 33) of shaft 10 and distal tip 30, with a proximal portion of cable tube 62 extending out from camera channel port 23 of handle 20 and extending out of the cable tube.
- the proximal end of is connected to a controller.
- a camera connector 70 is attached to the cable tube 62 of the camera 60 .
- This camera connector 70 is attached to the camera channel port 23 of the handle 20 when the cameras 60 are properly positioned in the camera channels 13 and 33 . That is, by attaching camera connector 70 to camera channel port 23 , camera 60 is properly positioned in camera channel 13 and camera channel 33 .
- the mounting position of the camera connector 70 is 300 to 5000 mm from the tip of the camera 60, and a preferred example is 2100 mm from the tip of the camera 60.
- the camera 60 can be separated from the handle 20 and the shaft 10 . That is, the camera connector 70 can be removed from the camera channel port 23 , and the cameras 60 arranged in the camera channels 13 and 33 can be removed together with the camera connector 70 from the camera channel port 23 of the handle 20 .
- the once separated camera 60 is inserted from the camera channel port 23 of the handle 20 into the camera channel 13 of the shaft 10 inside the handle 20 with the camera head 61 at the front, and the camera connector 70 is inserted into the camera channel port 23.
- the camera 60 can be reassembled as a component of the endoscope 100 .
- the tip of the camera 60 arranged in the camera channel 13 and the camera channel 33 is positioned above the tip surface 35 of the tip tip 30 where the camera channel 33 opens.
- a first position that is proximal (the distal position of the camera 60 as shown in FIG. 8A) and a second position that is distal to the distal surface 35 (the distal position of the camera 60 as shown in FIG. 8B).
- a camera position adjustment mechanism for reciprocating the camera 60 with respect to the camera channel 13 and the camera channel 33 so as to be displaced between .
- the distance from the first position to the second position (movement distance of the tip of the camera 60 by the position adjustment mechanism) is preferably 2 to 100 mm, and a preferred example is 30 mm. Further, the distance from the tip surface 35 of the tip 30 to the first position is preferably 1.5 to 20 mm, and the distance from the tip surface 35 to the second position is preferably 0.5 to 80 mm.
- the camera position adjusting mechanism of the camera connector 70 is a mechanism that reciprocates the camera 60 using a feed screw. Specifically, it is attached to the camera channel port 23, and a guide groove (not shown) extending along the axial direction is formed on the inner peripheral surface, and a guide hole 713 extending along the axial direction is formed on the peripheral wall.
- a connector case 71 Extending inside the connector case 71, a part of it extends to the base end side of the connector case 71, and a male screw part 722 is formed in the base end part, and the cable tube 62 of the camera 60 is inserted inside the connector case 71.
- a rotary knob 73 located on the base end side of the connector case 71 and restricted from moving in the axial direction and having a female threaded portion 731 screwed to the male threaded portion 722 of the shaft portion 721 of the slide member 72, By rotating the rotary knob 73 in one direction and sliding the slide member 72 from the proximal position to the distal position, the distal end of the camera 60 is moved from the first position (the distal position of the camera 60 as shown in FIG. 8A). Camera 60 is moved to the second position (the distal end position of camera 60 as shown in FIG. 8B), rotated rotary knob 73 in the other direction, and slides slide member 72 from the distal position to the proximal position. from the second position to the first position.
- proximal position is a position beyond which the slide member 72 cannot move proximally, as shown in FIG. 7A
- distal position is, as shown in FIG. It is a position beyond which it cannot move to the tip side.
- the camera position adjustment mechanism is composed of a connector case 71, a slide member 72, and a rotary knob 73.
- the connector case 71 is a constituent member of the camera connector 70 that is attached to the camera channel port 23 via a port-side connector, which will be described later, and is made of a tubular body having an arched portion.
- a guide groove extending along the axial direction is formed in the inner peripheral surface of the connector case 71, and a guide hole 713 extending along the axial direction is formed in the peripheral wall of the arch-shaped portion.
- the slide member 72 is composed of a shaft portion 721 and a guide portion 723 integrally formed with the shaft portion 721 so as to surround the tip portion of the shaft portion 721 .
- a shaft portion 721 of the slide member 72 extends inside the connector case 71 , and a portion of the shaft portion 721 extends from an opening formed in a proximal end surface 711 of the connector case 71 to the proximal side.
- a male threaded portion 722 is formed at the base end portion of the shaft portion 721 .
- the cable tube 62 of the camera 60 is inserted and fixed by adhesive.
- the guide portion 723 of the slide member 72 has an arch-shaped portion matching the shape of the connector case 71 and is integrally formed with the shaft portion 721 so as to surround the tip portion of the shaft portion 721 .
- the outer peripheral surface of the guide portion 723 is formed with a protruding portion that is guided by the guide groove of the connector case 71 .
- a projecting portion 725 guided by the guide hole 713 of the connector case 71 is formed on the outer peripheral side of the arch-shaped portion of the guide portion 723 .
- the rotary knob 73 is arranged on the proximal end side of the connector case 71 .
- a female threaded portion 731 is formed on the inner peripheral side of the rotary knob 73 to be screwed onto the male threaded portion 722 of the shaft portion 721 of the slide member 72 .
- the rotation knob 73 is restricted from moving in the axial direction with respect to the connector case 71 , and the slide member 72 slides with respect to the connector case 71 by rotating the rotation knob 73 . Further, by rotating the rotary knob 73 and sliding the slide member 72 , the cable tube 62 adhesively fixed inside the shaft portion 721 also moves in the axial direction with respect to the connector case 71 .
- the rotary knob 73 is rotated in one direction to move the slide member 72 from the proximal position (the position shown in FIG. 7A) to the distal position (the position shown in FIG. 7B). ) to move the tip of the camera 60 from the first position (the tip position of the camera 60 as shown in FIG. 8A) to the second position (the tip position of the camera 60 as shown in FIG. 8B).
- the rotary knob 73 By rotating the rotary knob 73 in the other direction to slide the slide member 72 from the distal position to the proximal position, the distal end of the camera 60 can be moved from the second position to the first position.
- the shaft 10 can be inserted into a bile duct, a pancreatic duct, or the like to diagnose the inside of the duct. It can be used therapeutically. Further, since the difference (D ⁇ d1) between the outer diameter (D) of the shaft 10 and the diameter (d1) of the camera channel 13 is 1.95 to 3.25 mm, the diameter (d2) of the forceps channel 17 is It can be 1.8 mm or more, preferably 1.9 mm or more, through which a widely used biological forceps can be inserted.
- the diameter (d1) of the camera channel 13 is 0.75 to 1.1 mm, which is smaller than that of a conventional endoscope, a certain proportion of the resin constituting the shaft 10 can be ensured. As a result, it is possible to prevent a kink from occurring in the tip flexible portion of the shaft.
- the ratio of the total area of the camera channel 13, the forceps channel 17, the water supply channels 141, 142, and the wire lumens 151, 152, 153, 154 to the area of the shaft 10 is 65% or less.
- the camera channel 13, the water supply channels 141 and 142, the wire lumens 151 and 153, and the forceps lumen 17 (protruding from the semicircular portion) are located in the semicircular portion on the side where the camera channel 13 is located.
- the ratio of the total area of the semicircular portion to the area of the semicircular portion is 58% or less, so that the rigidity of the shaft 10 in the semicircular portion where the camera 60 (optical fiber 65) is located is increased
- kink can be prevented, so that disconnection of the optical fiber 65 can be reliably prevented when the tip flexible portion 10A of the shaft 10 is bent.
- the tips of the operation wires 51 , 52 , 53 , 54 can be reliably fixed to the tip of the shaft 10 by the metal intermediate member 40 arranged between the shaft 10 and the tip 30 . That is, when the rear ends of the operation wires 51, 52, 53, 54 are pulled, the tip large diameter portions 511, 521, 531, 541 are caught in the secondary through holes 421, 422, 423, 424 of the intermediate member 40. Therefore, the movement of the distal ends of the operation wires 51, 52, 53, 54 in the proximal direction can be restricted. As a result, the tip flexible portion 10A of the shaft 10 can be reliably bent in the desired direction.
- the outer diameter of the intermediate member 40 is the same as the outer diameters of the shaft 10 and the tip 30, so that the outer peripheral surface of the shaft 10, the outer peripheral surface of the intermediate member 40, and the outer peripheral surface of the tip 30 are flush with each other. Therefore, the intermediate member 40 will not protrude from between the shaft 10 and the distal tip 30 and the edge thereof will not be exposed, and the edge of the intermediate member 40 will not damage the internal tissue.
- the tip of the shaft 10 is flexible unlike conventional endoscopes in which the tip of the operation wire is fixed by a cylindrical metal member.
- a smooth deflection operation can be performed by bending the entire area of the portion 10A.
- the shaft 10 and the distal tip 30 are directly joined (the constituent resins of both are welded together), the intermediate member 40 is also fixed by the resin inside the main through hole 41, and the intermediate member 40 rotates around the axis of the shaft 10. There is no such thing as causing a positional deviation to occur.
- the shaft 10 and the distal end tip 30 are directly joined inside the main through hole 41 of the intermediate member 40 and outside the communicating passages 43, 441, 442, 47.
- the intermediate member 40 made of metal is interposed between the tip 30 and the tip 30, the tip 30 can be firmly fixed to the shaft 10, and the tip 30 falls off from the tip of the shaft 10. - ⁇ There is no such thing.
- each of the distal end large diameter portions 511, 521, 531, 541 of the operating wires 51, 52, 53, 54 is embedded in the distal tip 30, when the operating wire 51 or 52 is pulled, this The distal end of the operating wire 52 or 51 facing the . does not move (extend) in the distal direction.
- the camera 60 can be incorporated as a component of the endoscope 100 and reused.
- the camera position adjustment mechanism reliably prevents the shaft 10 from being inserted into the delivery device or the body while the camera 60 is extended from the opening of the camera channel 33 on the distal end surface 35 of the distal tip 30. can do.
- the tip position of the camera 60 with respect to the tip surface 35 of the tip tip 30 can be finely adjusted by a camera position adjustment mechanism that reciprocates the camera 60 using a feed screw.
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Abstract
Description
本発明の目的は、胆管や膵管などの診断治療に使用可能な小型の内視鏡でありながら、汎用の生体鉗子を使用することができる内視鏡を提供することにある。
本発明の他の目的は、シャフトの先端可撓部分にキンクが起こりにくく、ライトガイド機構を構成する光ファイバが断線するようなことがない内視鏡を提供することにある。
が形成されてなる樹脂製のシャフトと、
前記シャフトの基端側に装着されたハンドルと、
撮像素子を搭載するカメラヘッドとケーブルチューブとを有し、前記カメラチャンネルおよび前記ハンドルの内部に挿通されることにより、前記シャフトおよび前記ハンドルに対して着脱可能に配置されるカメラとを備えてなり、
前記カメラチャンネルおよび前記鉗子チャンネルの中心軸は、それぞれ、前記シャフトの中心軸を含む同一平面上に位置し、
前記シャフトの外径(D)が2.8~4.1mm、
前記カメラチャンネルの径(d1)が0.75~1.2mm、
(D-d1)が1.95~3.25mmであることを特徴とする。
また、シャフトの外径(D)とカメラチャンネルの径(d1)との差(D-d1)が1.95~3.25mmであることにより、汎用されている生体鉗子を挿通可能な鉗子チャンネルを当該シャフトに形成することができる。
これにより、外径が1.75mm程度の汎用の生体鉗子を挿通することができる。
これにより、外径が1.85mm程度の汎用の生体鉗子を挿通することができる。
また、本発明の内視鏡を構成するカメラは、シャフトに対して着脱可能に配置されている(シャフトに固定されていない)ので、シャフトの先端可撓部分が曲げられるときに、カメラチャンネル内をカメラが軸方向に移動することで、カメラの内部に位置する光ファイバへの負荷を緩和することができる。
および/またはルーメンの一部が前記半円部分からはみ出しているときには、前記半円部分に位置している残部)の合計面積の前記半円部分の面積に占める割合が58%以下(シャフトを構成する樹脂の割合が42%以上)であることが好ましい。
前記シャフトの先端側に配置され、前記シャフトと実質的に同一の外径を有し、前記シャフトの前記カメラチャンネル、前記鉗子チャンネルおよび前記送水チャンネルの各々に連通して、その先端面で開口するカメラチャンネル、鉗子チャンネルおよび送水チャンネルが形成されている樹脂製の先端チップと、
前記シャフトと前記先端チップとの間に配置された前記シャフトと実質的に同一の外径を有する板状であって、前記シャフトの前記カメラチャンネル、前記鉗子チャンネルおよび前記送水チャンネルの各々と、前記先端チップの前記カメラチャンネル、前記鉗子チャンネルおよび前記送水チャンネルの各々との連通路を確保するために、当該連通路のすべてを取り囲むように形成された主貫通穴と、前記ワイヤルーメンの形成位置に対応して形成された4つの副貫通穴とを有する金属製またはセラミックス製の中間部材と、
前記先端チップに埋設された、前記中間部材の前記副貫通穴の直径よりも大きな直径の先端大径部を有し、前記副貫通穴の各々を通って、前記シャフトの前記ワイヤルーメンの各々に延在する4本の前記操作用ワイヤとを備えていることが好ましい。
また、操作用ワイヤの後端を引張操作したときに、先端大径部によるシャフトの先端面に対する基端方向への押圧力が中間部材により分散される(押圧力の集中が緩和される)ことにより、シャフトを構成する樹脂の割合が高くなくても先端可撓部分におけるキンクが起こることを更に効果的に防止することができる。
また、シャフトの先端可撓部分にキンクが起こりにくく、ライトガイド機構を構成する光ファイバが断線することを防止することができる。
本発明の実施形態について説明する。
図1~図8(図8Aおよび図8B)に示すこの実施形態の内視鏡100は、十二指腸内視鏡などの側視鏡の鉗子ルーメンに挿通されて、胆管または膵管における疾患を診断治療するため使用される。
この内視鏡100は、先端可撓部分10Aを有し、カメラチャンネル13、2つの送水チャンネル141,142および鉗子チャンネル17が形成されているとともに、4つのワイヤルーメン151,152,153,154が形成されている樹脂製のシャフト10と;
シャフト10の基端側に配置され、回転操作部(操作ノブ25および操作ノブ26)を備えたハンドル20と;
シャフト10の先端側に配置され、シャフト10と同一の外径を有し、シャフト10のカメラチャンネル13、送水チャンネル141,142および鉗子チャンネル17の各々に連通して、その先端面35で開口するカメラチャンネル33、送水チャンネル341,342および鉗子チャンネル37が形成されている樹脂製の先端チップ30と;
シャフト10と先端チップ30との間に配置され、シャフト10と同一の外径を有する円板状であって、シャフト10のカメラチャンネル13、送水チャンネル141,142および鉗子チャンネル17の各々と、先端チップ30のカメラチャンネル33、送水チャンネル341,342および鉗子チャンネル37の各々との連通路43,441,442,47を確保するために、当該連通路43,441,442,47のすべてを取り囲むように形成された主貫通穴41と、シャフト10のワイヤルーメン151,152,153,154の形成位置に対応して形成された4つの副貫通穴421,422,423,42
4とを有する金属製の中間部材40と;
先端チップ30に埋設された、中間部材40の副貫通穴421,422,423,424の直径よりも大きな直径の先端大径部511,521,531,541を有し、副貫通穴421,422,423,424の各々を通って、シャフト10のワイヤルーメン151,152,153,154の各々に延在し、それぞれの後端が、ハンドル20の回転操作部(操作ノブ25または操作ノブ26)に固定されて引張操作可能である4本の操作用ワイヤ51,52,53,54と;
CMOSイメージセンサ611(撮像素子)を搭載するカメラヘッド61と、ケーブルチューブ62とにより構成され、複数本の光ファイバ65を内蔵し、カメラチャンネル13およびハンドル20の内部に挿通されることにより、シャフト10およびハンドル20に対して着脱可能に配置されるカメラ60とを備えてなり;
シャフト10に形成されたカメラチャンネル13および鉗子チャンネル17の中心軸は、それぞれ、シャフト10の中心軸を含む同一平面上に位置し、シャフト10の外径(D)が2.8~4.1mm、カメラチャンネル13の直径(d1)が0.75~1.1mm、シャフト10外径とカメラチャンネルの直径との差(D-d1)が1.95~3.25mmである。
また、シャフト10には、操作用ワイヤ51,52,53,54の挿通路であるワイヤルーメン151,152,153,154が形成されている。
ここに、「先端可撓部分」とは、操作用ワイヤの後端を引張操作することによって撓む(曲がる)ことのできるシャフトの先端部分をいう。
先端可撓部分10Aの長さとしては5~200mmであることが好ましく、好適な一例を示せば20mmである。
このような小径のシャフト10であれば、胆管や膵管に挿入して、当該管内の診断治療を行うことができる。
5~3.25mmであることにより、鉗子チャンネル17の直径(d2)を、外径が1.75mm以上の汎用の生体鉗子を挿通することが可能なサイズ(1.8mm以上)とすることができる。
(D-d1)が1.95mm未満であると、汎用の生体鉗子を挿通できる鉗子チャンネルを形成することができないか、きわめて困難となる。
(D-d1)が3.25mmを超えると、シャフトの外径を4.1mm以下とすることができないか、きわめて困難となる。
(d1)が0.75mm未満であると、カメラを挿通することができないか、きわめて困難となる。
(d1)が1.1mmを超えると、(D-d1)を3.25mm以下とすることができないか、きわめて困難となる。
鉗子チャンネル17の直径(d2)が1.8mm以上であることにより、従来の内視鏡によっては挿通することのできない外径が1.75mm程度の汎用の生体鉗子を挿通することが可能となり、鉗子チャンネル17の直径(d2)が1.9mm以上であることによれば、外径が1.85mm程度の汎用の生体鉗子を挿通することも可能となる。
また、汎用の生体鉗子は、従来の内視鏡で挿通可能な外径4Fr(1.33mm)以下の鉗子と比較して格段に安価である。
ワイヤルーメン151,152,153,154の直径(d4)は0.2~0.5mmであることが好ましく、好適な一例を示せば0.33mmである。
、半円部分の面積〔π(D)2 /8〕に占める割合が58%以下(シャフトを構成する樹脂の割合が42%以上)であることが好ましく、更に好ましくは49~53%、好適な一例を示せば51%である。
シャフト10を構成する樹脂材料としては、ナイロン樹脂、ポリエーテルブロックアミド(PEBAX)樹脂、ポリウレタン樹脂およびポリオレフィン樹脂などを挙げることができ、これらのうち、PEBAX樹脂およびポリウレタン樹脂が好ましい。
内視鏡100を構成するハンドル20は、グリップ21と、回転操作部として2つの操作ノブ25,26とを備えてなる。
図3A、図3Cおよび図6Bに示すように、内視鏡100を構成する先端チップ30には、カメラチャンネル33と、送水チャンネル341,342と、鉗子チャンネル37とが形成されている。
送水チャンネル341,342は、それぞれ、連通路441,442を介して、シャフト10の送水チャンネル141,142と連通している。送水チャンネル341,342の直径は、これと連通する送水チャンネル141,142の直径と同一である。
鉗子チャンネル37は、連通路47を介して、シャフト10の鉗子チャンネル17と連通している。鉗子チャンネル37の直径は、これと連通する鉗子チャンネル17の直径と同一である。
先端チップ30の外径は、シャフト10の外径と同一である。
先端チップ30を構成する樹脂材料としては、シャフト10を構成する樹脂として例示したものと同様の樹脂を挙げることができ、それらのうち、PEBAX樹脂およびポリウレタン樹脂が好ましい。
体内組織を傷つけないために、先端チップ30は、低硬度の樹脂材料により構成される。先端チップ30の構成樹脂の硬度(ショアD硬度)は72D以下であることが好ましく
、好適な一例を示せば25Dとされる。
内視鏡100を構成する中間部材40は、操作用ワイヤ51,52,53,54の各々の先端をシャフト10の先端に固定する(後端の引張操作時に抜け止めする)ための部材である。
副貫通穴421,422,423,424は円形の穴であり、それらの直径は、挿通される操作用ワイヤ51,52,53,54の直径より大きく、挿通を規制すべき先端大径部511,521,531,541の直径より小さく調整される。
副貫通穴の直径としては0.13~2.5mmであることが好ましく、好適な一例を示せば0.35mmである。
中間部材40の厚さが過小であると、操作用ワイヤ51,52,53,54の引張操作に伴う機械的衝撃を受けて、中間部材40が破損してしまうおそれがある。
他方、この厚さが過大であると、中間部材40自体が撓みにくいため、先端可撓部分10Aを撓ませにくくなるおそれがある。
が好ましい。
中間部材40を構成する金属材料としては、ステンレス銅、白金、金、銅、ニッケル、チタン、タンタルなどを挙げることができ、それらのうち、ステンレス銅が好ましい。
また、部分的ではあるが、シャフト10と先端チップ30とが直接接合されていることにより、シャフト10に対する先端チップ30の固着力も十分に高いものとなる。
先端大径部511,521,531,541は、中間部材40の副貫通穴421,422,423,424の直径よりも大きな直径を有する球状または部分球状であり、副貫通穴421,422,423,424を通過することができない。
先端大径部511,521,531,541の直径としては、0.2~3.5mmであることが好ましく、好適な一例を示せば0.4mmである。
操作用ワイヤ51,52,53,54(先端大径部以外の部分)の直径としては、0.1~2.0mmであることが好ましく、好適な一例を示せば0.25mmである。
操作ノブ25を他方向に回転して操作用ワイヤ52の基端を引張操作することにより、操作用ワイヤ52がワイヤルーメン152を基端方向に移動する。このとき、先端大径部521は中間部材40の副貫通穴422に引っ掛かって基端方向への移動が規制されるので、シャフト10の先端可撓部分10Aが、図3Aの矢印A2に示す方向に撓み、内視鏡100(先端チップ30)の先端が同方向に偏向する。
に延在している。操作用ワイヤ53,54の基端は、それぞれ、ハンドル20の操作ノブ26に固定されている。
操作ノブ26を他方向に回転して操作用ワイヤ54の基端を引張操作することにより、操作用ワイヤ54がワイヤルーメン154を基端方向に移動する。このとき、先端大径部541は中間部材40の副貫通穴424に引っ掛かって基端方向への移動が規制されるので、シャフト10の先端可撓部分10Aが、図3Aの矢印A4に示す方向に撓み、内視鏡100(先端チップ30)の先端が同方向に偏向する。
もし、シャフトと先端チップとの間に中間部材を配置しないと、操作用ワイヤの基端を引張操作したときに、操作用ワイヤの先端(先端大径部)をシャフトの先端に対して十分に固定(抜け止め)することができず、先端大径部がワイヤルーメンを押し広げながら基端方向に移動することがあり、その場合には、先端可撓部分を撓ませることができなくなる。
これにより、光ファイバを配置するためのチャンネルを別途形成する必要がなく、シャフト10の小径化、装置の小型化を十分に図ることができる。
また、内視鏡100を構成するカメラ60は、シャフト10に対して着脱可能に配置されている(シャフト10に固定されていない)ので、シャフト10の先端可撓部分10Aが曲げられるときに、カメラチャンネル13内をカメラ60が軸方向に移動することで、カメラ60の内部に位置する光ファイバ65への負荷を緩和することができる。
このカメラコネクタ70は、カメラチャンネル13およびカメラチャンネル33にカメラ60が適正に配置されているときに、ハンドル20のカメラチャンネルポート23に装着される。
すなわち、カメラチャンネルポート23にカメラコネクタ70を装着することにより、カメラ60は、カメラチャンネル13およびカメラチャンネル33に適正に配置される。
カメラコネクタ70の取付け位置としては、カメラ60の先端から300~5000mmとされ、好適な一例としては、カメラ60の先端から2100mmである。
すなわち、カメラチャンネルポート23からカメラコネクタ70を取り外し、カメラチャンネル13およびカメラチャンネル33に配置されているカメラ60を、カメラコネクタ70とともに、ハンドル20のカメラチャンネルポート23から抜去することができる。
また、先端チップ30の先端面35から第1位置までの距離は1.5~20mmであることが好ましく、先端面35から第2位置までの距離は0.5~80mmであることが好ましい。
具体的には、カメラチャンネルポート23に装着され、軸方向に沿って延びるガイド溝(図示せず)が内周面に形成されているとともに、軸方向に沿って延びるガイド孔713が周壁に形成されているコネクタケース71と;
コネクタケース71の内部に延在して、その一部が当該コネクタケース71の基端側に延出し、その基端部分に雄ねじ部722が形成され、カメラ60のケーブルチューブ62が、その内部に挿通された状態で接着固定されているシャフト部721と、シャフト部721の先端部分を取り囲むようにして当該シャフト部721と一体的に形成され、コネクタケース71のガイド溝に案内される凸条部(図示せず)が外周面に形成されているとともに、ガイド孔713に案内される突起部725が外周側に形成されているガイド部723とからなり、コネクタケース71に対してスライド可能なスライド部材72と;
コネクタケース71の基端側に位置して軸方向の移動が規制され、スライド部材72の
シャフト部721の雄ねじ部722に螺合する雌ねじ部731を有する回転摘み73とを備え、
回転摘み73を一方向に回転して、スライド部材72を基端位置から先端位置までスライドさせることにより、カメラ60の先端を第1位置(図8Aに示したようなカメラ60の先端位置)から第2位置(図8Bに示したようなカメラ60の先端位置)まで移動させ、回転摘み73を他方向に回転して、スライド部材72を先端位置から基端位置までスライドさせることにより、カメラ60の先端を第2位置から第1位置に移動させる機構である。
コネクタケース71の内周面には、軸方向に沿って延びるガイド溝が形成されているとともに、アーチ状部分の周壁には、軸方向に沿って延びるガイド孔713が形成されている。
シャフト部721の基端部分には雄ねじ部722が形成されている。
図7Aおよび図7Bに示すように、シャフト部721の内部には、カメラ60のケーブルチューブ62が挿通された状態で接着固定されている。
ガイド部723の外周面には、コネクタケース71のガイド溝に案内される凸条部が形成されている。
また、ガイド部723のアーチ状部分の外周側には、コネクタケース71のガイド孔713に案内される突起部725が形成されている。
回転摘み73の内周側には、スライド部材72のシャフト部721の雄ねじ部722に螺合する雌ねじ部731が形成されている。
回転摘み73は、コネクタケース71に対する軸方向の移動が規制されており、回転摘み73を回転することにより、コネクタケース71に対してスライド部材72がスライドする。
また、回転摘み73を回転させてスライド部材72がスライドすることにより、シャフト部721の内部に接着固定されているケーブルチューブ62も、コネクタケース71に対して軸方向に移動することになる。
また、シャフト10の外径(D)とカメラチャンネル13の径(d1)との差(D-d1)が1.95~3.25mmであることにより、鉗子チャンネル17の直径(d2)を、汎用されている生体鉗子を挿通可能な1.8mm以上、好ましくは1.9mm以上とすることができる。 また、カメラチャンネル13の径(d1)が0.75~1.1mmと、従来の内視鏡と比較して小さいことにより、シャフト10を構成する樹脂の割合をある程度確保することができ、この結果、シャフトの先端可撓部分にキンクが起こることを防止することができる。
て、そのエッジが露出するようなことはなく、中間部材40のエッジによって体内組織などを傷付けることがない。
10 シャフト
10A 先端可撓部分
13 カメラチャンネル
130 シャフトおよび/または先端チップの構成樹脂
141,142 送水チャンネル
151,152,153,154 ワイヤルーメン
17 鉗子チャンネル
20 ハンドル
21 グリップ
23 カメラチャンネルポート
25,26 操作ノブ
27 鉗子チャンネルポート
30 先端チップ
35 先端チップの先端面
33 カメラチャンネル
341,342 送水チャンネル
37 鉗子チャンネル
40 中間部材
41 主貫通穴
421,422,423,424 副貫通穴
43,441,442,47 連通路
51,52,53,54 操作用ワイヤ
511,521,531,541 操作用ワイヤの先端大径部
60 カメラ
61 カメラヘッド
611 CMOSイメージセンサ
62 ケーブルチューブ
65 光ファイバ
70 カメラコネクタ
71 コネクタケース
711 基端面
713 ガイド孔
72 スライド部材
721 シャフト部
722 雄ねじ部
723 ガイド部
725 突起部
73 回転摘み
731 雌ねじ部
Claims (10)
- 先端可撓部分を有し、カメラチャンネルおよび鉗子チャンネルが形成されてなる樹脂製のシャフトと、
前記シャフトの基端側に装着されたハンドルと、
撮像素子を搭載するカメラヘッドとケーブルチューブとを有し、前記カメラチャンネルおよび前記ハンドルの内部に挿通されることにより、前記シャフトおよび前記ハンドルに対して着脱可能に配置されるカメラとを備えてなり、
前記カメラチャンネルおよび前記鉗子チャンネルの中心軸は、それぞれ、前記シャフトの中心軸を含む同一平面上に位置し、
前記シャフトの外径(D)が2.8~4.1mm、
前記カメラチャンネルの径(d1)が0.75~1.2mm、
(D-d1)が1.95~3.25mmであることを特徴とする内視鏡。 - 前記鉗子チャンネルの径(d2)が1.8~3.1mmであることを特徴とする請求項1に記載の内視鏡。
- 前記鉗子チャンネルの径(d2)が1.9~2.1mmであることを特徴とする請求項1に記載の内視鏡。
- 前記カメラが、光ファイバを含むライトガイド機構を有していることを特徴とする請求項2または3に記載の内視鏡。
- 前記シャフトの横断面視において、前記カメラチャンネルおよび前記鉗子チャンネルを含むすべてのチャンネルまたはルーメンの合計面積の前記シャフトの面積に占める割合が65%以下であることを特徴とする請求項4に記載の内視鏡。
- 前記シャフトの横断面視において、前記カメラチャンネルが位置している側の半円部分における前記すべてのチャンネルまたはルーメン(チャンネルおよび/またはルーメンの一部が前記半円部分からはみ出しているときには、前記半円部分に位置している残部)の合計面積の前記半円部分の面積に占める割合が58%以下であることを特徴とする請求項5に記載の内視鏡。
- 前記シャフトには、0.4~1.0mmの径(d3)を有する2つの送水チャンネルと、0.2~0.5mmの径(d4)を有する4つのワイヤルーメンとが形成され、前記ワイヤルーメンの各々には、後端を引張操作可能な操作用ワイヤが延在しており、前記後端を引張操作することにより、前記シャフトの先端が偏向するよう構成されていることを特徴とする請求項4~6の何れかに記載の内視鏡。
- 前記シャフトの基端側に配置され、回転操作部を備えた前記ハンドルと、
前記シャフトの先端側に配置され、前記シャフトと実質的に同一の外径を有し、前記シャフトの前記カメラチャンネル、前記鉗子チャンネルおよび前記送水チャンネルの各々に連通して、その先端面で開口するカメラチャンネル、鉗子チャンネルおよび送水チャンネルが形成されている樹脂製の先端チップと、
前記シャフトと前記先端チップとの間に配置された前記シャフトと実質的に同一の外径を有する板状であって、前記シャフトの前記カメラチャンネル、前記鉗子チャンネルおよび前記送水チャンネルの各々と、前記先端チップの前記カメラチャンネル、前記鉗子チャンネルおよび前記送水チャンネルの各々との連通路を確保するために、当該連通路のすべてを取り囲むように形成された主貫通穴と、前記ワイヤルーメンの形成位置に対応して形成された4つの副貫通穴とを有する金属製またはセラミックス製の中間部材と、
前記先端チップに埋設された、前記中間部材の前記副貫通穴の直径よりも大きな直径の先端大径部を有し、前記副貫通穴の各々を通って、前記シャフトの前記ワイヤルーメンの各々に延在する4本の前記操作用ワイヤとを備えていることを特徴とする請求項7に記載の内視鏡。 - 側視鏡の鉗子ルーメンに挿通される子内視鏡として使用される請求項1~8の何れかに記載の内視鏡。
- 胆管または膵管における疾患を診断治療するための請求項1~9の何れかに記載の内視鏡。
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2021
- 2021-02-09 WO PCT/JP2021/004757 patent/WO2022172321A1/ja active Application Filing
- 2021-02-09 JP JP2022581044A patent/JPWO2022172321A1/ja active Pending
- 2021-02-09 DE DE112021007058.4T patent/DE112021007058T5/de active Pending
- 2021-02-09 CN CN202180093147.8A patent/CN116829045A/zh active Pending
- 2021-11-30 TW TW110144545A patent/TW202233120A/zh unknown
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2023
- 2023-08-02 US US18/364,012 patent/US20230371799A1/en active Pending
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RU2805798C1 (ru) * | 2023-03-06 | 2023-10-24 | Марат Касимович Давлиев | Устройство для эндоскопии и способ его использования (варианты) |
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TW202233120A (zh) | 2022-09-01 |
DE112021007058T5 (de) | 2024-03-21 |
JPWO2022172321A1 (ja) | 2022-08-18 |
CN116829045A (zh) | 2023-09-29 |
US20230371799A1 (en) | 2023-11-23 |
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