JPH08546A - Endoscope device - Google Patents

Abstract

PURPOSE:To provide an endoscope device which makes a treatment condition easily visible and to permit easy and exact treatment. CONSTITUTION:This endoscope device provided with an observation window 19 of an observation means and an aperture 14 of a channel for insertion of a treatment means in an insertion part 2 is provided with the observation window 19 of the observation means in front of the aperture 14 of the channel for insertion of the treatment means so that an operation field is observed from the projecting front of the treatment means 18 projecting from the aperture 14 of the channel for insertion of the treatment through the observation window 19. The section to be treated exists on the operator side and the treatment means 18 exists deeply than this side at the time of observation from the observation window and, therefore, the section to be treated and the front end of the treatment means 18 are made visible sufficiently larger over the entire part on the screen of, for example, a monitor 24.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscopic device which is inserted into a living body for observation and treatment inside the living body.

[0002]

2. Description of the Related Art When performing a treatment in a living body cavity using a conventional endoscope, it becomes as shown in FIGS. 32 (a) and 32 (b). That is, the opening 20 of the treatment instrument insertion channel provided in the insertion portion 201 of the endoscope and opened in the distal end surface 202 thereof.
3, the treatment tool 205 is projected toward the treatment target portion 204, while the state of the treatment work is observed by the eyepiece or the monitor 209 through the observation window 208 provided on the distal end surface 202 of the insertion portion 201. .

[0003]

However, in the observation situation, as shown in the screen of the monitor 209 shown in FIG. 32 (b), the protruding portion of the treatment instrument 205 on the proximal side looks extremely large, and the treatment instrument is observed. It looks smaller toward the tip side of 205. A treatment target portion 204 such as a polyp to be treated with the distal end portion of the treatment instrument 205 looks smaller, and it is difficult to grasp the state and the sense of distance. Moreover, not only that, as the tip of the treatment tool 205 approaches the treatment target site 204, a part or all of the treatment target site 204 is hidden behind the treatment tool 205, and in particular, the treatment of the minute treatment target site 204 is performed. It's hard to do.

In such an observing situation, generally, not only is it difficult to carry out the treatment work, but also it is difficult to perform the treatment accurately, especially even for a minute treatment target portion.

The present invention has been made in view of the above problems, and its purpose is to make it easy to see the treatment situation,
Moreover, it is an object of the present invention to provide an endoscope device that can be treated easily and accurately.

[0006]

SUMMARY OF THE INVENTION The present invention relates to an endoscope apparatus in which an insertion portion is provided with an observation window of an observation means and an opening of a treatment instrument insertion channel. The observation window of the observation means is provided in front of the surgical instrument, and the operative field is observed from the front of the protrusion of the treatment instrument protruding from the opening of the treatment instrument insertion channel through the observation window.

According to this, when observing through the observation window, the treatment target site is in the front and the treatment tool is in the back, so that, for example, on the screen of the monitor, the treatment target site and the tip of the treatment tool are sufficiently large and the overall treatment tool. You will be able to see it well.

[0008]

【Example】

(First Embodiment) A first embodiment of the present invention will be described with reference to FIGS. [Structure] FIG. 1A shows a usage state in which observation and treatment are performed with an endoscope inside a tubular organ 1 such as a large intestine. The insertion section 2 of the endoscope is formed by connecting the flexible tube section 3, the bending tube section 4, and the distal end forming section 5 in order from the proximal end side. The flexible tube portion 3 is composed of a thicker proximal end side portion 3a made of a flexible tube body and a thinner distal end side portion 3b also made of a flexible tube body, and has a thicker proximal end side portion 3a.
The thin tip side portion 3b is connected to the tip of the. The bending tube portion 4 has an outer diameter that is substantially the same as that of the thin tip side portion 3b. The tip forming portion 5 is connected to the tip of the thin tip side portion 3b via the bending tube portion 4. The thicker proximal end portion 3a and the distal end forming portion 5 are coaxial with each other with substantially the same outer diameter, and the thicker proximal end portion 3a and the narrower distal end portion 3b connecting the distal end constituting portion 5 have the insertion portion 2 It is arranged so as to be biased toward one side with respect to the central axis of.

As shown in FIGS. 2 and 3, the bending tube portion 4 connected to the tip of the thin tip side portion 3b has a plurality of bending pieces 6 having a minute short tube shape arranged in the axial direction. The adjacent bending pieces 6 are rotatably connected to each other to form a bending core material, and an outer tube 7 made of silicon resin or the like is fitted on the outer circumference of the bending core material. As shown in FIG. 2, the tip end of the thin tip side portion 3b and the base end of the bending tube portion 4 are fitted to each other, and the thread 8 is provided on the outer periphery of the overlapping portion.
The two are connected by winding and fastening.

As shown in FIG. 4, wire receivers 9 are formed at the upper and lower positions on the inner surface of each bending piece 6, and a bending operation wire 10 is inserted over these wire receivers 9. Then, the distal end of the bending operation wire 10 is connected to the most distal bending piece 6 or the member of the distal end forming portion 5, while the proximal end side portion of the bending operation wire 10 is inserted through the inside of the flexible tube portion 3 of the insertion portion 2. The bending tube portion 4 is bent toward the pulled bending operation wire 10 by guiding the bending operation wire 10 toward the proximal side of the endoscope and pushing and pulling the operation portion of the endoscope, for example.

The base end portion of the thin front end side portion 3b is connected to the thick base end side portion 3a through a mouthpiece 11 attached to the front end of the thick base end portion 3a. The two parts 3a and 3b are connected in a communicating state.

As shown in FIGS. 2 and 5, a channel tube 12 made of a fluororesin such as so-called Teflon is provided inside the thicker proximal portion 3a of the flexible tube portion 3 from the proximal side of the insertion portion 2. The channel tube 12 is inserted and arranged over the tip, and the tip of the channel tube 12 is the base 11
It is fixedly attached through the. The tip end of the channel tube 12 is open facing diagonally forward so as not to interfere with the thin tip side portion 3b and the bending tube portion 4. That is, the channel tube 12 forms the treatment instrument insertion channel 13 and the opening portion 14 thereof. And the opening 14
Is provided on the hand side of the above-mentioned tip forming section 5 and provided in the middle of the insertion section 2. In this embodiment, in particular, the flexible tube portion 3 is provided on the wall surface portion of the step boundary having a large diameter on the way, and is provided so as to face diagonally forward on the side opposite to the thin tip side portion 3b.

As shown in FIG. 3, the main body 15 of the tip forming portion 5 provided in front of the bending tube portion 4 has an observation function and an illumination function. That is, as an observing function, a CCD 16 of a solid-state image pickup device is provided, and an objective lens 17 for forming an image on the CCD 16 is incorporated in a hand side end wall (observation surface) of the main body 15. The visual field direction observed by the objective lens 17 is toward the rear side (opposite direction to the insertion direction) of the insertion portion 2 and the state of the treatment instrument 18 protruding from the opening 14 of the treatment instrument insertion channel 13 described above, An observation window 19 for observing from the front side of the tip of the treatment instrument 18 protruding therefrom is configured.

A signal cable 20 is connected to the CCD 16. The signal cable 20 includes the bending tube portion 4 of the insertion portion 2.
The flexible tube portion 3 is guided through the inside to the proximal side of the endoscope. Then, it can be observed by a camera control unit, an image processing circuit, and a monitor (not shown).

Further, a pair of illumination windows 21 for illuminating the observation visual field from the observation window 19 is provided on the end wall of the main body 15 on the hand side. An illumination function is configured by connecting a light guide cable 22 to each of the pair of illumination windows 21. The light guide cable 22 is the main body 1
5 is bent into a U shape inside, and further, as shown in FIG.
Also, as shown in FIG. 5, the bending tube portion 4 and the flexible tube portion 3 of the insertion portion 2 are guided to the proximal side of the endoscope through the inside.
The light guide cable 22 transmits illumination light from an illumination light source device (not shown) to each illumination window 21 to illuminate the observation visual field.

[Operation] As shown in FIG. 1 (a), the organ 1
The insertion portion 2 of the endoscope is introduced into the interior of the endoscope, the treatment instrument 18 is inserted through the treatment instrument insertion channel 13, and the treatment instrument 18 is projected obliquely forward from the opening 14 of the channel 13, for example, a polyp 23. Perform excision work. The work status at this time can be observed by the above-mentioned observation function. That is, the visual field image of the monitor screen 24 is as shown in FIG. 1A, and the operation can be observed from the front of the tip of the treatment instrument 18.

[Effect] On the monitor screen 24, the opening 14 of the channel 13 and the root portion of the treatment instrument 18 protruding therefrom are seen as extremely small and distant, but the tip of the treatment instrument 18 and the polyp 23 to be treated are Relatively large and clearly visible. Even if the treatment target site is small, it can be seen well without being hidden by the shadow of the treatment tool 18. Therefore, the operator is prevented from performing a wrong treatment even for a small lesion site. In addition, it is possible to treat easily.

As a modified example of this embodiment, if another bending portion is provided in the portion of the flexible tube portion 3 located behind the opening 14 of the channel 13 so that the bending operation can be performed, the treatment is performed. It becomes easier to aim in the direction. Further, when the front end face side of the distal end forming portion 5 is provided with another observation function for front or perspective as in the conventional endoscope, when the insertion portion 2 of the endoscope is inserted into the body cavity. By using the front observation function, good insertion performance can be obtained, and the rear observation function surface can be switched to perform selective observation when performing treatment or as necessary. Further, bend the bending operation wire 10 up and down 2
Although the bending tube portion 4 is bent in two directions in the up and down direction by providing this, the bending tube portion 4 may be bent in the entire circumferential direction by providing three pieces at 120 degree intervals or four pieces at 90 degree intervals. is there. (Second Embodiment) A second embodiment of the present invention will be described with reference to FIGS. 6 and 7.

[Structure] This embodiment is a modification of the endoscope of the first embodiment described above, and is the portion of the insertion portion 2 excluding the distal end constituting portion 5 of the endoscope described above, that is, a thicker portion. A flexible tube portion 3 composed of a proximal end side portion 3a and a narrow distal end side portion 3b,
The curved tube portion 4 is formed by a so-called multi-lumen tube having a plurality of lumens.

As shown in FIG. 7 (a), the flexible relatively thin multi-lumen tube 31 forming the portion extending from the thin tip side portion 3b to the curved tube portion 4 is curved above and below the peripheral portion, respectively. A lumen 32 having a small diameter through which the operation wire 10 is passed is formed, and a lumen 33 having a relatively large diameter through which various built-in objects such as the signal cable 20 and the light guide cable 22 are passed is formed at the center.

Further, as shown in FIG. 7B, the relatively thick multi-lumen tube 34 forming the thicker proximal end portion 3a of the flexible tube portion 3 has the treatment instrument insertion channel 13 in the upper peripheral portion. A lumen 35 to be formed, a lumen 36 through which various built-in objects as described above are passed, and a small diameter lumen 37 through which the bending operation wire 10 is passed are formed above and below the lumen 36, respectively. The lumen 36 communicates with the lumen 33, and the lumen 37 includes the lumen 32.
The multi-lumen tube 31 and the multi-lumen tube 34 are integrally molded or integrally connected so that they communicate with each other linearly.
Similarly to the above, the opening 14 of the treatment instrument insertion channel 13 formed by the lumen 35 is opened obliquely forward so as not to interfere with the thin distal end side portion 3b and the bending tube portion 4.

Further, in the multi-lumen tube 31,
A heat-shrinkable tube 38 is fitted on the outer periphery of a portion of the flexible tube portion 3 corresponding to the thinner tip side portion 3b, leaving a portion to be the curved tube portion 4. By fitting the heat-shrinkable tube 38 and heat-shrinking the heat-shrinkable tube 38, the fitted part of the multi-lumen tube 31 becomes relatively hard, and the distal end portion left without fitting the heat-shrinkable tube 38 is the curved tube portion 4. Can be The other structure is similar to that of the first embodiment described above.

[Operation] When the bending operation wire 10 is pulled, the bending tube portion 4 can be bent in that direction. Observation of the work status is the same as described above.

[Effect] According to this embodiment, since the multi-lumen tubes 31 and 34 can be used in the insertion part 2, a simplified structure can be obtained.

The bending of the bending tube portion 4 is not stored in the bending operation wire 10, but a shape memory alloy member is embedded in the lumen of the multi-lumen tube 31 and is energized and heated to a memory shape stored in the bending shape. It may be a system of returning and bending driving, or a system of bending driving using a shape memory alloy member that expands and contracts due to temperature change instead of the bending operation wire. (Third Embodiment) A third embodiment of the present invention will be described with reference to FIGS.

[Structure] In this embodiment, a curved pipe portion 43 is installed over the large diameter portion of the flexible tube portion 41 of the insertion portion 2 and the distal end portion 42, and the curved pipe portion 43 is installed.
A pair of bending operation wires 44 are disposed between the distal end forming portion 42 and the distal end of the large diameter portion of the flexible tube portion 41 located outside. The tip of the bending operation wire 44 is attached to the member of the tip forming portion 42. Bending operation wire 44
The proximal portion of the is guided to the proximal side of the endoscope through a guide hole 45 formed in the flexible tube portion 41. Then, for example, the operation section of the endoscope is pushed and pulled. Other structures except this curved structure are the above-mentioned first and second.
It is similar to the embodiment of.

[Operation] As shown in FIG. 9, the pair of bending operation wires 44 has the right and left vertices of the base of the isosceles triangle when the position of the bending tube portion 43 is the vertex of the inverted isosceles triangle. It is located in each. Therefore, when one of the bending operation wires 44 is pulled, the bending tube portion 43 can be bent in either of the left and right diagonal directions. If loosened, the elasticity of the bending tube portion 43 returns to a straight state. Further, when both of the bending operation wires 44 are pulled, the bending operation wires 44 can be bent in a direction within the range of the hatched area in FIG. 9 according to the ratio of the pulling amounts. If it is pulled evenly, it can be bent upward as shown in FIG. (Fourth Embodiment) A fourth embodiment of the present invention will be described with reference to FIG.

[Structure] The thickness of the flexible tube portion 51 in the insertion portion 50 of the endoscope is thinner and substantially uniform as compared with the distal end configuration portion 52 over the entire length. It is inserted inside. The inner hole of the tube 53 has an inner diameter sufficiently larger than the outer diameter of the flexible tube portion 51, and is provided so as to be slidable in the axial direction while covering the flexible tube portion 51. The tube 53 may be the same as the sliding tube used to straighten the flexible tube portion 51 when inserting the endoscope into the large intestine, for example. The distal end opening of the tube 53 is an opening 55 through which the treatment tool 54 projects.

The inner diameter of the tube 53 is larger than the outer diameter of the flexible tube portion 51 and the outer diameter of at least one treatment tool 54. Of course, the inner hole of the tube 53 is shown in FIG.
The shape may be an ellipse or an ellipse in order to eliminate the dead space.

Further, as in the case of the first embodiment described above, a curved portion 56 is formed at the tip portion of the flexible tube portion 51. Furthermore, an observation window 57 and a pair of illumination windows 58 are provided rearward on the rear end surface of the tip forming portion 52.

[Operation] According to this embodiment, the tube 5
Since the treatment tool 54 can be projected from the opening 55 of the No. 3 tube and the tube 53 can slide on the flexible tube section 51, the operator can also perform the treatment work of projecting the treatment tool 54 toward the treatment target site 59. Can be set to an easy position.

[Effects] This embodiment is an example in which the openings of the insertion portion and the treatment tool insertion channel are modified, and can be realized without making the flexible tube portion 51 thick from the middle to the base end side. Further, the flexible tube portion 51 of the endoscope can be made thinner and more uniform in diameter than in the first embodiment, and the protruding position of the treatment tool 54 can be changed to a position desired by the operator.

Further, if the inner diameter of the tube 53 is increased, it is possible to insert a plurality of treatment tools 54, and it is possible to cope with complicated treatment. If the tube 53 is a multi-lumen tube, the treatment target portion 59 for the flexible tube portion 51
The protruding direction of can be determined. If the tube 53 is detachable from the flexible tube portion 51 and the distal end forming portion 52 of the endoscope, the endoscope can be easily washed. Tube 53 can be attached and detached
Can be inserted and removed from the tip of the endoscope.

Further, a slit may be cut in the axial direction of the tube 53 to attach / detach it from the side of the flexible tube portion 51. Then, the inner diameter of the tube 53 can be made smaller than the outer diameter of the tip forming portion 52, and the tube can be made compact.

The tube 53 is a sliding tube,
That is, if the tube 53 is harder than the flexible tube portion 51, the insertability of the flexible tube portion 51 and the distal end forming portion 52 of the endoscope into the body cavity can be improved.

Although the tube 53 here is formed of a single lumen tube as shown in FIG. 11, a multi-lumen tube of 2 lumens, 3 lumens or the like is used to form the flexible tube portion 51 and the treatment instrument 54. Etc. may be inserted into the lumen. In addition, the inner diameter of the tube 53 is larger than the outer diameter of the distal end forming portion 52, and the tube 53 is the flexible tube portion 51 or the distal end forming portion 52 of the endoscope.
It may be more detachable. (Fifth Embodiment) This embodiment is an example of a self-propelled endoscope, which will be described with reference to FIGS. 12 and 13.

[Structure] As shown in FIG. 12, a self-propelled device 62 is connected to the distal end of the flexible tube portion 61 of the insertion portion 60 of the endoscope. This self-propelled device 62 has a front balloon 64.
And a rear balloon 65 and an expansion / contraction portion 66 that is provided between the rear balloons 65 and 65 so as to be capable of advancing and retracting and interposed therebetween. The front balloon 64 and the rear balloon 65 have a plurality of slants 67 on their surfaces, and these slants 67 are made of a resin such as so-called Teflon or urethane,
It is protruding rearward with respect to the forward direction. Also,
Disc-shaped guide portions 68 are provided in front of and behind the front balloon 64 and the rear balloon 65, and the outer diameter of the guide portion 68 is the outer peripheral surface when the front and rear balloons 64 and 65 are contracted. Larger than the outer diameter of.

On the rear end surface of the member 70 for holding the rear balloon 65, the observation window 7 is formed as in the case of the first embodiment.
One and a pair of illumination windows 72 are provided rearward. The distal end of the flexible tube portion 61 of the endoscope is then the balloon 6
It is connected to the member 70 holding 5 at a deviated position while avoiding the observation field of view directed rearward. This relationship is the same as in the first embodiment described above.

On the other hand, the flexible tube portion 61 is inserted into one lumen 74 of the multi-lumen tube 73, and the other lumen of the multi-lumen tube 73 is the treatment instrument 7.
A treatment instrument insertion channel 77 through which 6 is inserted is formed. Then, from the opening of the channel 77, the treatment tool 76
Is projected toward the area of the observation visual field.

Inside the flexible tube portion 61, the light guide, the CCD cable, the fluid conduit and the like as described above are incorporated. Further, the front and rear balloons 64, 65 and the expansion / contraction portion 66 are driven by the fluid sent from the fluid conduit.

[Operation] The operation of the self-propelled device 62 will be schematically described with reference to FIG. As shown in FIG. 13 (a), initially, the front balloon 64 and the expansion / contraction part 66 are contracted, and the rear balloon 65 is expanded to grip the lumen wall 78.

Next, as shown in FIG. 13B, the expansion / contraction portion 66 is extended. Then, the front end portion advances. next,
As shown in FIG. 13 (c), the front balloon 64 is inflated to grip the lumen wall 78.

Finally, as shown in FIG. 13 (d), the rear balloon 65 is deflated and the telescopic portion 66 is also deflated. Then, the rear end portion advances. By repeating such a procedure, the self-propelled device 62 moves forward in a so-called imago type.
Then, the flexible tube portion 61 of the insertion portion 60 is pulled to advance it.

Here, since the front and rear balloons 64, 65 have the slanted hair 67 directed rearward, the balloon 6
When the members 4 and 65 are inflated, they are less likely to slip in the direction opposite to the forward insertion direction, and the lumen wall 78 can be reliably gripped. Further, since the front and rear balloons 64 and 65 have the guide portions 68 in front and rear, when the front and rear balloons 64 and 65 are deflated and the endoscope is pulled out in the direction opposite to the insertion direction, the slanted hair 67 causes the lumen wall 7 to move.
Prevents getting stuck in 8.

The operation of the multi-lumen tube 73 is similar to that of the above-mentioned fourth embodiment. Further, since the flexible tube portion 61 does not have a channel for inserting the treatment tool, the flexible tube portion 6
The diameter of 1 can be made quite thin and soft. In addition, the self-propelled device 6
When 2 pulls the flexible tube portion 61 of the endoscope, the load is reduced and it becomes easier for the vehicle to self-propell. In addition to the effects of the fourth embodiment, the self-propelled device 62 is easy to self-propell.

The illumination window 72 is not on the observation surface, which is the rear end surface of the member 70 holding the rear balloon 65, but on the front end surface of the multi-lumen tube 73, and the light guide is built in the multi-lumen tube 73. Is also good. When the illumination window 72 is thus provided on the multi-lumen tube 73 side, the flexible tube portion 61 can be made thinner and softer. (Sixth Embodiment) This embodiment shows an endoscope equipped with a self-propelled device for self-propelling an insertion portion, which is inserted into a living body and actively moved in the living body. The present invention relates to an endoscope capable of (self-propelled). This embodiment will be described with reference to FIGS. 14 and 15.

[Structure] In this endoscope, the insertion portion 81
Is connected to the tip of the flexible tube portion (flexible tube portion) 82 via the bending portion 83, and the tip forming portion 84 is connected.
A first observation surface 85 facing forward is formed at the tip of the. An observation window 86 and an illumination window 8 are provided on the first observation surface 85.
7. An opening 88 of the forceps insertion channel is provided. It should be noted that the distal end forming portion 84 is not provided with the expanding and contracting means in the circumferential direction such as the balloon as described above.

A self-propelled device 89 is attached to the tip forming portion 84. That is, immediately behind the tip forming portion 84, a stretchable portion 91 that is stretchable and flexible in the axial direction is connected and provided. The expansion / contraction portion 91 is formed in a so-called bellows shape, and is expanded by supplying a pressurized fluid to the hollow portion in the wall portion thereof, and contracts when the pressurized fluid is discharged.

The slide member 9 is provided at the rear end of the expandable portion 91.
2 are provided. On the outer peripheral surface of the slide member 92,
A plurality of extendable legs 93 that project obliquely rearward are provided. The expansion / contraction part 91 is a curved part 83 in the insertion part 81.
The slide member 92 is provided at a position to cover the flexible tube portion 83 when the expansion / contraction portion 91 is at least extended and preferably contracted.

The plurality of legs 93 are provided on the outer peripheral surface of the slide member 92 at, for example, four positions in the vertical and horizontal directions. These legs 93 are made of rubber material, have a hollow center, and are formed into a bent shape as shown in the drawing. Then, normally, although it is folded in the contracted state, when the inside is pressurized, the folded portion extends linearly and extends so as to project obliquely rearward.

A fluid conduit (not shown) for driving the telescopic portion 91 and the legs 93 with a fluid is a flexible tube portion 82, and the operation portion 9 of the endoscope.
4 and a flexible cable 95, which fluid line connects to a pressure pump 96. The operation unit 94 of the endoscope is provided with a self-propelled operation switch 97 and a curving operation switch 98 for controlling self-propelling and bending driving. Further, the operation portion 94 is provided with an insertion port 99 which communicates with the forceps insertion channel.

Since this endoscope constitutes an electronic endoscope, it is equipped with a video processor 101 and a TV monitor 102, and also with a light source device 103 for illumination, like a general endoscope device. ing.

[Operation] The operation will be described with reference to FIG. The figure (a) has shown the initial state, and since the pressurization flow is not supplied to the leg 93, the leg 93 is bent and contracted, and is in contact with the body cavity wall 104 in this state. . From this state, rapid pressurization is applied to the leg 93,
When the legs 93 are instantaneously extended as shown in (b), the legs 93 linearly extend while the tips are locked to the body cavity wall 104, thereby propelling the slide member 92. At this time, when the expansion / contraction part 91 is also pressurized and extended, the tip forming part 84 is advanced based on the slide member 92 provided with the legs 93. The tip forming portion 84 and the slide member 92 move forward by sliding with respect to the flexible tube portion 82. That is, in FIG. 15 (b), the tip forming portion 84 of the self-propelled device 89.
And the flexible tube portion 82 advances.

Next, when the expandable portion 91 and the legs 93 are decompressed, as shown in FIG. 15C, the heavy-weight flexible tube portion 82.
Is already in the advanced position, and the extension portion 91 and the leg 93 are
Contracts. In its advanced position, FIG. 15 (a)
Return to the initial state indicated by. By repeating this, the insertion portion 81 of the endoscope can be advanced.

[Effect] However, according to the configuration of this embodiment, the expansion / contraction portion 91 and the legs 93 of the self-propelled device 89 are extended, so that the self-propelled device of the fifth embodiment described above is further improved. You can surely make a big step forward.

As in the fifth embodiment described above, a second observation surface having an observation window for observing the rear and an illumination window is provided at the rear portion of the slide member 92, and the flexible tube portion 82 of the endoscope or The tube 7 in the above-mentioned fifth embodiment for inserting the treatment tool.
It is advisable to observe the surgical field of the treatment tool that is drawn out from the opening of No. 3. Further, this type of second observation surface may be provided at the rear end portion of the front end forming portion 84. (Seventh Embodiment) This embodiment shows a modification of the sixth embodiment. In FIG. 16, the leg (front leg) 105 is also provided on the tip forming portion 84 located in front of the expandable portion 91 of the self-propelled device 89. This leg 105
It expands and contracts similarly to the legs (rear legs) 93 provided on the slide member 92, but is formed slightly smaller than that. Then, when the leg 93 provided on the slide member 92 is contracted from the extended state, the leg 93 is extended and locked to the body cavity wall 104, and the tip forming portion 8
4 is to prevent the rear leg 93 from retracting when the rear leg 93 contracts.

That is, the procedure shown in FIGS. 16 (a) and 16 (b) operates in the same manner as described above, but at the stage shown in FIG. 16 (c), when the expansion / contraction portion 91 and the rear leg 93 are contracted, By extending the leg 105 of the body, the body cavity wall 104 is locked, and the tip forming portion 84 is prevented from retracting even a little. In some cases, it can also be advanced by the front leg 105. Therefore, rather than the sixth embodiment described above,
In addition, it is possible to make a great progress.

Instead of the rear leg 93 and the front leg 105, which contract and fold, and then extend and straighten, at least one of the legs 93 and 105 is slanted backward as shown in FIG. It may be one that extends and contracts in a substantially straight direction. (Eighth Embodiment) This embodiment shows a modification of the sixth embodiment described above. That is, this embodiment
In this example, a plurality of self-propelled devices are connected in series to enhance the propulsive force of the endoscope. This will be described with reference to FIG.

That is, the self-propelled device 89 as described above is provided at the distal end forming portion 84 of the insertion portion 81 of the endoscope, which is the same as the above-described embodiment, but the self-propelled device 89 is provided at a plurality of positions in the insertion portion 81. Running devices 106 and 107 are provided.

[Operation] These self-propelled devices 89, 106,
The operation of 107 is as described above in FIG.
They are only plural. According to the configuration in which the self-propelled devices are connected in series, the propulsive force of the insertion portion 81 of the endoscope can be increased without increasing the size of each self-propelled device.

These plural self-propelled devices 89, 106, 10
If 7 are operated in synchronization, the number of fluid conduits in the insertion portion 81 can be equal to the number of one self-propelled device 89, and the insertion portion 81 does not have to be thick. Is also possible. (Ninth Embodiment) This embodiment shows a modification of the self-propelled device in the above-mentioned seventh embodiment. As shown in FIG. 19, in the self-propelled device 110 in this embodiment, each body member of the tip forming portion 84 and the slide member 92 is formed in a rectangular shape with a rounded corner, and each of the four corners Legs 93 and 105 are provided at the respective portions. The number of legs 93 and 105 may be more than that.

The tip surface (observation surface) of the tip forming portion 84
Two sets of the observation window 111 and the illumination window 112 are provided in the camera, and stereoscopic viewing is possible. The observation window 111 is provided on the left and right sides above the illumination window 112.
The reference numeral 12 is provided on the lower side and is located on the left and right. And
Stereoscopic viewing is performed by observing through the left and right observation windows 111 by a general method.

[Operation] FIG. 20 schematically shows an operation pattern of the self-propelled device 110. This FIG. 20 shows the self-propelled device 11
Although it is seen from the side of 0, in this figure, ○ marks are the front legs 93 and 105, and Δ marks are the rear legs 93 and 10.
5 is shown, and the black coating shows the extended legs 93 and 105.

FIG. 20A shows the initial standby state, and the legs 93 and 105 are both contracted. First, FIG.
As shown in (b), in the front-rear relationship between the four legs 93 on the leading end side and the four legs 105 on the trailing end side, two legs 93, 105 that intersect point-symmetrically are provided. Extend. Next, when they contract, as shown in FIG. 20 (c), the remaining two legs 93 and 105 extend.

Although not shown in the drawing, the four legs 93 on the front end side first extend, and when they contract, the four legs 105 on the rear end side extend, and so on. Each leg 93, 105 may be operated. Alternatively, the extension may be alternately performed due to the vertical relationship.

In any case, according to this method, it is possible to make a small advance. Therefore, a small amount of forward movement is possible,
Suitable for detailed observation and treatment. In addition, when it is desired to make a large forward movement, it is preferable to use the extension of the expansion / contraction portion 91 to perform the forward movement operation as described above. (Tenth Embodiment) This embodiment relates to an improvement of the self-propelled endoscope as described above. 21 to 25
Will be described with reference to.

[Structure] As shown in FIG. 21, a self-propelled device unit 122 is provided on the outer periphery of the distal end portion of the insertion portion 121 of the endoscope. This self-propelled device unit 122 is shown in FIG. Is configured. The self-propelled device unit 122 is fixed to the outer circumference of the distal end of a flexible elastic tube 123 in a state where the front balloon 124 is fitted, and the rear balloon 125 is fitted to the outer circumference of the rear end of the elastic tube 123. Is slidably fitted via a slide ring 126. A bellows (stretchable portion) 127 as a stretchable member is provided at an intermediate portion between the balloons 124 and 125. The front and rear balloons 124 and 125 are connected via a bellows 127.

Each of the balloons 124 and 125 is made of, for example, so-called latex, and these form airtight spaces 128 and 129 therein.
An airtight space 130 is formed between the bellows 127 and the elastic tube 123.

In each airtight space 128, 129, 130,
Pressurizing tubes 131 for pressurizing or sucking the inside of the balloons 124 and 125 and the bellows 127 are individually connected.

The pressure tube 131 is the elastic tube 12
An external device installed on the side of the operation part of the endoscope passes along the inner hole of the endoscope 3. That is, the pressure tube 1
Reference numeral 31 is connected to a supply compressor 135, a suction device 136 for sucking the pressurized fluid, and a control device 137 for adjusting timings of pressurization and suction.

On the other hand, the insertion portion 121 has a flexible illumination function tube 141 and a flexible observation function tube 14 respectively.
2 and a channel tube 143 for inserting a treatment tool such as forceps or for supplying air and water. These tubes 141, 142, 143 are slidably provided with respect to the self-propelled device section 122 via hooks 144 provided in the vicinity of the tip ends thereof, using the pressure tube 131 as a guide. The illumination function tube 141 is the light source device 145, and the observation function tube 142 is the video processor 146 and the TV monitor 1.
It is connected to 47.

[Operation] When the endoscope is inserted into the lumen, first, only the self-propelled device section 122 is self-propelled to the target site. The procedure of this self-propelled operation is shown in FIG. That is, first, after inserting the self-propelled device portion 122 into the lumen 148, as shown in FIG. 7A, a pressurized fluid is supplied to the front balloon 124 to expand it in the radial direction, and the inner wall of the tube is expanded. Press and hold.

Next, as shown in FIG. 6B, when the fluid in the airtight space of the bellows 127 is sucked and the bellows 127 is contracted in the axial direction, the rear balloon 125 in the contracted state is accordingly drawn. Moves to the front balloon 124 side.
Further, as shown in FIG.
Fluid is supplied to the tube to expand it in the radial direction and press it against the inner wall of the tube to hold it.

As shown in FIG. 3D, the front balloon 1
When the fluid is sucked from 24 and supplied to the bellows 127, the bellows 127 expands in the axial direction, so that the front balloon 124 and the elastic tube 123 advance. The fluid is again supplied to the front balloon 124, pressed against the inner wall of the tube, held therein, and then the fluid of the rear balloon 125 is sucked. After that, by repeating the above operation,
The self-propelled device unit moves forward.

After the self-propelled device section 122 reaches the target site by the above operation, as shown in FIG. 25 (a), fluid is supplied to the front balloon 124 and the rear balloon 125 and pressed against the inner wall of the tube to be held. Then, the self-propelled device unit 122 is fixed. 25A to 25C, the illumination function tube 141, the observation function tube 142, and the channel tube 143 are sequentially pushed in from the entrance of the lumen 148 using the pressure tube 131 as a guide. The tips of these tubes 141, 142, 143 are inserted along the pressure tube 131 into the self-propelled device section 122, respectively, and are bundled together, so that they are assembled to function as an endoscope.

As shown in FIG. 26, first, only the self-propelled device section 122 is self-propelled to a target site in the lumen 148, and pressurized fluid is supplied to the front balloon 124 and the rear balloon 125. Hold it against the inner wall of the tube. Next, the illumination function tube 141, the observation function tube 142, and the channel tube 143 are pushed in from the entrance of the lumen 148, and the functions of the respective function tubes 141, 142, 143 are activated before reaching the self-propelled device unit 122,
Observations and treatments may be made.

In this case, the inside of the lumen 148 can be observed and treated while the endoscope insertion portion is being inserted, and the examination time can be shortened. Lumen 148
If there is a site to be treated closer to the entrance side of the lumen 148 than the target site inside, appropriate measures and treatments can be taken immediately.

[Effect] According to the endoscope apparatus of this embodiment, first, since only the self-propelled device unit 122 is inserted into the lumen 148, the self-propelled device unit 122 is lightly weighted by itself. As compared with a self-propelled endoscope that is integrated with the endoscope section, quick and reliable self-propelled can be expected.

After the self-propelled device section 122 reaches the target site, when the endoscope section is inserted along the pressure tube 131, the endoscope section is illuminated by the illumination function tube 141 and the observation function tube. Since the tube is divided into the 142 and the channel tube 143, the flexibility of each tube is high, and it is easy to insert the tube into the site where the inner diameter of the lumen 148 is small or the site is complicated. (Eleventh Embodiment) This shows a modification of the tenth embodiment described above, and as shown in FIG.
Illumination function tube 1 of the endoscope insertion portion in the embodiment of
41 and the observation function tube 142 may be shared by one tube, and this one tube 151 may be provided with an illumination function and an observation function. According to this, the insertion part 12
1 includes an illumination / observation function tube 151 and a channel tube 143.

After the self-propelled device section 122 reaches the target portion,
Illumination and observation function tube 1 when inserting the endoscope section
51 and the channel tube 143 may be inserted, and the insertion time can be shortened. Further, when the purpose of use of the endoscope is only for observation, only the illumination / observation function tube 151 may be inserted, and the insertion operation can be simplified. (Twelfth Embodiment) This is a modification of the tenth embodiment described above, and as shown in FIG.
The endoscope insertion portion in the embodiment is a self-propelled endoscope having a tube 152 having an illumination function and a channel and an observation function tube 142.

According to this, the illumination / channel function tube 152 and the observation function tube 142 are inserted when the endoscope section is inserted after the self-propelled device section 122 reaches the target site.
It suffices to insert two of them, and the insertion time can be shortened. (Thirteenth Embodiment) This is a modification of the tenth embodiment described above, and as shown in FIG.
The endoscope insertion part in the embodiment is a tube self-propelled endoscope including a tube 153 having an observation function and a channel, and an illumination function tube 141.

According to this, after the self-propelled device section 122 reaches the target site, when inserting the endoscope section, the observation / channel function tube 153 and the illumination function tube 141 can be inserted. Well, the insertion time can be shortened. (Fourteenth Embodiment) This is a modification of the tenth embodiment described above, and as shown in FIG.
The endoscope insertion portion in the embodiment is an intratube self-propelled endoscope including one tube 154 having an observation function, an illumination function and a channel.

According to this, after the self-propelled device section 122 reaches the target site, one tube 154 may be inserted when inserting the endoscope section, and the insertion time can be shortened. (Fifteenth Embodiment) This is a modification of the tenth embodiment described above, and as shown in FIG.
It is an intra-tube self-propelled endoscope which has a tube 155 with a treatment tool such as grasping forceps in place of the channel tube 143 in the embodiment.

According to this, when the treatment after the insertion is predetermined such as when the endoscope is inserted into the body cavity for the purpose of biopsy of the tissue in the intestine, it is time-consuming to insert the treatment instrument into the channel. It can be saved and the inspection time can be shortened. Further, the clearance between the inner diameter of the channel and the treatment tool is not required, and the diameter can be reduced.

The endoscope device of the present invention is not limited to various medical devices, but can be applied to industrial devices. [Addition] (Group A) A (1). In an endoscopic device having an observation means and a treatment instrument insertion channel in the insertion section, the observation direction of the observation means is directed toward the rear side of the insertion section, and the opening of the treatment instrument insertion channel is set to the observation section. An endoscope apparatus characterized in that it is provided so as to be located on the rear hand side.

A (2). In the above A (1), the insertion part is
A curved portion is provided behind the opening of the channel. A (3). In A (1) above, another observation means is provided with the visual field direction facing the front of the insertion part.

A (4). In A (1) above, the channel is formed by a tube that covers the other members of the insertion portion and is slidable in the axial direction. A (5). In A (4) above, a clearance is formed between the insertion portion and the tube so that a plurality of treatment tools can be inserted therethrough.

A (6). In the above A (4), the tube was composed of a multi-lumen tube having a lumen for inserting an insertion portion and a lumen for inserting a treatment tool. A (7). In A (4) above, the tube was made detachable with respect to other members of the insertion portion.

A (8). In A (7) above, the tube was detachable from the side of the insertion part. A (9). In (4) above, the tube is made of a material that is harder than the other members of the insertion portion.

A (10). In A (1) above, a self-propelled device is provided, for example, at the tip of the insertion portion. A (11). In A (1) above, the illumination means is behind the observation means. (Group B) B (1). An endoscopic device having an intra-body-cavity self-propelled device which is provided with an axial expansion / contraction means and a locking means for locking on an inner wall of a body cavity, and advances by combining locking by the locking means and expansion / contraction of the axial expansion / contraction means, The endoscope device characterized in that the locking means is composed of a leg made of an elastic material, and a pressurized fluid is supplied to a hollow portion inside the leg to extend the leg.

B (2). In the above-mentioned B (1), the legs are provided before and after the axial expansion / contraction means. B (3). In B (2), the front leg and the rear leg of the axial expansion / contraction means were alternately operated.

B (4). In the above B (2), a plurality of legs are provided in front of and behind the axial expansion / contraction means, and the plurality of legs are alternately operated. B (5). In B (1) above, the self-propelled devices in the body cavity are provided at a plurality of positions in the endoscope insertion portion.

B (6). In B (5), a plurality of self-propelled devices were operated synchronously. In particular, as a conventional example of the group B, Japanese Patent Publication No. 51-15678 can be cited. In this system, two balloons and a bellows for axial expansion and contraction are provided between the two balloons at the tip of the endoscope, and the endoscope self-propels by a caterpillar type motion.

In such a structure, there is a problem that it is difficult to securely lock the flexible inner wall of the lumen due to the inflation of the balloon. In order to solve the above problem, a leg made of an elastic material is provided as a means for locking the inner wall of the lumen instead of the balloon, and a pressurized fluid is supplied to the hollow portion in the leg,
By extending diagonally rearward, the tip of the leg can be securely locked so that it can be inserted into the inner wall of the lumen, and can be advanced by both extension of the leg and extension of the bellows. According to this, it is possible to provide a self-propelled mechanism that can move forward more reliably than in the past.

(Group C) C (1). An endoscopic device having an intratube self-propelled mechanism at an endoscope insertion portion, wherein at least one member constituting the self-propelled mechanism is slidably provided.

C (2). At C (1), the endoscope insertion portion is divided into a plurality of flexible tubes having a function. C (3). In C (1), the endoscope insertion portion is divided into a flexible tube having an illumination function, a flexible tube having an observation function, and a flexible tube having a lumen.

C (4). At C (1), the endoscope insertion portion is divided into a flexible tube having an illumination / observation function and a flexible tube having a lumen. C (5). In C (1), the in-tube self-propelled mechanism includes a plurality of lumen inner wall locking means, an axial expansion / contraction means, locking / unlocking timing of the locking means, and expansion / contraction of the axial expansion / contraction means. And a control device for controlling the timing.

C (6). In C (5), the lumen inner wall locking means is a balloon made of a highly elastic material, the axial expansion / contraction means is a bellows, and a pressure tube is independently provided for the balloon and the bellows. A means for supplying / sucking the pressurized fluid is connected thereto, and the control means is a control means for controlling the timing of supply / suction.

C (7). In C (6), the balloon is made of latex. C (8). In C (6), the balloon is made of silicone rubber. C (9). In the C (6), the bellows is made of latex.

C (10). In C (6), the bellows is made of silicone rubber. C (11). In C (1), the endoscope insertion part is divided into a plurality of flexible tubes having a function, and the intra-tube self-propelled mechanism includes a plurality of lumen inner wall locking means, and axial expansion / contraction means. A control device for controlling the timing of locking / unlocking the locking means and the timing of expansion / contraction of the axial expansion / contraction means.

C (12). At C (11), the endoscope insertion portion is divided into a flexible tube having an illumination function, a flexible tube having an observation function, and a flexible tube having a lumen. C (13). At C (11), the endoscope insertion portion is divided into a flexible tube having an illumination / observation function and a flexible tube having a lumen.

C (14). In C (1), the endoscope insertion part is divided into a plurality of flexible tubes having a function,
The in-tube self-propelled mechanism includes a plurality of lumen inner wall locking balloons, a bellows as an axial expansion / contraction means provided in the middle of the balloon, and a pressurizing tube independently provided on the balloon and the bellows. , A means for supplying / suctioning a pressurized fluid to the balloon and the bellows via a pressure tube, and a control means for controlling the timing of supply / suction. The guide is slidably provided with respect to the in-pipe self-propelled mechanism.

Particularly, as a conventional example of the group C, Japanese Patent Publication No. 51-15678 can be cited. This shows an endoscope self-propelled device in which a bellows made of an elastic body is provided in an outer peripheral portion in the middle of an endoscope insertion portion, and balloons are provided on both end sides of the bellows. The self-propelled device of this endoscope inflates the rear balloon and presses it against the inner wall of the insertion channel to hold it, then sends pressurized fluid to the bellows made of an elastic body and extends it in the longitudinal direction to extend the tip of the insertion part. To move forward. After this, the front balloon is inflated and pressed against and held against the inner wall of the insertion conduit. After this, the rear balloon is deflated, and the bellows are deflated to the original state, whereby the rear portion of the insertion portion is pulled and advanced. By repeating this, the insertion portion of the endoscope is made to run by itself.

Further, in Japanese Laid-Open Patent Publication No. 1-204640, an endoscope for observing the inside of a tube self-propelled device, an endoscope for observing the inside of the tube, and a rear end from the rear end of the in-tube self-propelled device part are provided. An endoscopic traction, which comprises a detachable traction member at its tip, and traction means for traction of the endoscope at a distance between the endoscopic self-propelled device section and the endoscope to secure an observation visual field. A self-propelled device is shown.

However, said Japanese Patent Publication No. 51-1567
In the self-propelled device for endoscopes proposed in Japanese Patent Laid-Open No. 8 and JP-A-1-204640, the self-propelled device unit must be self-propelled with an endoscope heavier than the self-propelled device unit. However, it becomes a load resistance when moving forward, and there is a problem that stable self-propelling is difficult or the self-propelling speed is slow. It is possible to provide a self-propelled endoscope in the tube which solves the above-mentioned problems and can move forward quickly and surely.

[0106]

As described above, according to the present invention, since the treatment target site is in the front and the treatment tool is in the back, the treatment target site and the tip of the treatment tool are sufficiently large on the monitor screen, for example. It will look good on the whole. Even a small treatment target portion can be accurately treated.

[Brief description of drawings]

FIG. 1A is an explanatory diagram of a usage state of an endoscope apparatus according to a first embodiment of the present invention, and FIG. 1B is an explanatory diagram showing a state of a monitor screen thereof.

FIG. 2 is a longitudinal sectional view of the vicinity of the tip of the insertion portion of the endoscope.

FIG. 3 is a longitudinal cross-sectional view of the vicinity of the distal end constituent portion of the insertion portion of the endoscope.

FIG. 4 is a sectional view taken along the line AA in FIG.

5 is a cross-sectional view taken along the line BB in FIG.

FIG. 6 is a vertical cross-sectional view of the vicinity of the distal end portion of the endoscope insertion portion according to the second embodiment of the present invention.

7A is a sectional view taken along the line AA in FIG.
(B) is sectional drawing which follows the BB line in FIG.

FIG. 8 is a side view of the vicinity of the distal end portion of the endoscope insertion portion according to the third embodiment of the present invention.

FIG. 9 is a front view of the distal end of the endoscope insertion portion.

FIG. 10 is a side view of the vicinity of the distal end portion of the insertion portion of the endoscope in a curved state.

FIG. 11 is a perspective view of the vicinity of the distal end portion of the endoscope insertion portion according to the fourth embodiment of the present invention.

FIG. 12 is an explanatory diagram of a usage state of the endoscope apparatus according to the fifth embodiment of the present invention.

FIG. 13 is an explanatory view of the operation of the self-propelled device.

FIG. 14 is a perspective view of an endoscope apparatus according to a sixth embodiment of the present invention.

FIG. 15 is an explanatory view of the operation of the self-propelled device.

FIG. 16 is an explanatory diagram of the operation of the self-propelled device in the endoscope device according to the seventh embodiment of the present invention.

FIG. 17 is a side view of a modified example of the self-propelled device.

FIG. 18 is an explanatory diagram of an endoscope apparatus according to an eighth embodiment of the present invention.

19A is a side view of a self-propelled device according to a ninth embodiment of the present invention, and FIG. 19B is a front view thereof.

FIG. 20 is an explanatory diagram showing an operating procedure of the self-propelled device.

FIG. 21 is an explanatory diagram of an endoscope apparatus according to a tenth embodiment of the present invention.

FIG. 22 is a front view of the tip of the insertion portion of the endoscope device.

FIG. 23 is a side view of the self-propelled device of the endoscope apparatus.

FIG. 24 is an explanatory view of an operation procedure of the self-propelled device of the endoscope apparatus.

FIG. 25 is an explanatory view of the procedure for introducing the insertion portion of the endoscope device.

FIG. 26 is an explanatory view of another procedure for introducing the insertion portion of the endoscope device.

FIG. 27 is a front view of the distal end of the endoscope insertion portion according to the eleventh embodiment of the present invention.

FIG. 28 is a front view of the distal end of the endoscope insertion portion according to the twelfth embodiment of the present invention.

FIG. 29 is a front view of the distal end of the endoscope insertion portion according to the thirteenth embodiment of the present invention.

FIG. 30 is a front view of the distal end of the endoscope insertion portion according to the fourteenth embodiment of the present invention.

FIG. 31 is a front view of the distal end of the endoscope insertion portion according to the fifteenth embodiment of the present invention.

FIG. 32 is an explanatory diagram of a conventional endoscope.

[Explanation of Codes] 2 ... Insertion portion, 19 ... Observation window of observation means, 14 ... Opening portion of treatment instrument insertion channel, 18 ... Treatment instrument.

 ─────────────────────────────────────────────────── ─── Continued front page (72) Inventor Hideyuki Adachi 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Inventor Yasuhiro Ueda 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd.

Claims (1)

[Claims] 1. An endoscope apparatus in which an insertion portion is provided with an observation window of an observation means and an opening of a treatment instrument insertion channel, wherein the observation means is observed in front of the opening of the treatment instrument insertion channel. An endoscopic device characterized in that a operative field is observed from a front side of a projection of a treatment instrument which is provided with a window through the observation window and protrudes from an opening of the treatment instrument insertion channel.