Endoscope auxiliary device

Abstract

To provide an endoscope auxiliary device that reduces the burden on doctors and subjects and enables the safe treatment by being used together with an endoscope.SOLUTION: An endoscope auxiliary device used in conjunction with a tip part of an endoscope comprises: a detachment mechanism which detaches the endoscope auxiliary device from the tip part in an observation space of the endoscope; a fixation mechanism which is fixed in the observation space by being deployed after detachment from the tip part and pressing the inner wall of the observation space; a support part which is supported by the fixation mechanism; a device which is installed on the support part; and a supply mechanism which supplies energy to the device. By using this endoscope auxiliary device together with the endoscope, imaging by an imaging unit and a treatment by a treatment tool can be performed stably from different directions in the observation space independently of imaging by the imaging unit and the treatment by the treatment tool provided in the endoscope.SELECTED DRAWING: Figure 2

Description

[Technical field]

[0001] The present invention relates to an endoscope auxiliary device. [Background technology]

[0002] There is known an endoscopic system that inserts an endoscope into a subject's body cavity to perform an examination based on images of the target area captured by a camera unit and remove any lesions that are discovered using an electric scalpel or forceps attached to the tip of the endoscope.

[0003] In general, the tip of an endoscope is inserted into a body cavity of a subject and pushed in until it reaches an observation space including a target site. The tip of the endoscope pushed in the body cavity in this way comes into contact with or is close to the surface of the body cavity in the reached observation space, so that a sufficient field of view cannot be secured, and problems have arisen such as the camera unit being unable to properly image the target site. In response to such problems, a technology has been developed in which balloons arranged before and after the tip of the endoscope are inflated in the reached observation space to generate a certain volume of void space in the observation space (see, for example, Patent Document 1). In the void space secured in this way, for example, a camera unit provided at the tip can take an overhead image of the target site, so a doctor can judge the presence or absence of a lesion by looking at the properly captured image. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] Special Publication No. 2017-506132 Summary of the Invention [Problem to be solved by the invention]

[0005] However, the camera unit and treatment tool provided at the tip of the endoscope are naturally restricted to act in one direction from the tip side. That is, the camera unit can only take an image from the tip of the endoscope toward the target part, and if an electric scalpel is provided as a treatment tool, the electric scalpel can only be extended from the tip of the endoscope to cut the target part. It is not desirable for a doctor to operate a treatment tool with such a limited field of view from the viewpoints of ensuring safety, requiring skilled techniques, and shortening treatment time. That is, there is a demand for a technology that ensures a viewpoint that is not affected by the operation of the tip of the endoscope in the observation space, that makes the direction of treatment and the direction of the viewpoint different, and that enables treatment from multiple directions.

[0006] The present invention has been made to solve such problems, and provides an endoscopic auxiliary device that, when used in conjunction with an endoscope, reduces the burden on doctors and patients, enabling safer treatment. [Means for solving the problem]

[0007] An endoscopic auxiliary device in one aspect of the present invention is an endoscopic auxiliary device used in conjunction with the tip of an endoscope, and includes a detachment mechanism for detaching the endoscopic auxiliary device from the tip in the observation space of the endoscope, a positioning mechanism for deploying the endoscopic auxiliary device after detachment from the tip and pressing against the inner wall surface of the observation space to position it in the observation space, a support section supported by the positioning mechanism, a device installed on the support section, and a supply mechanism for supplying energy to the device. Effect of the Invention

[0008] According to the present invention, it is possible to provide an endoscopic auxiliary device that, when used together with an endoscope, reduces the burden on a doctor or a subject and enables safe treatment. Specifically, by using such an endoscopic auxiliary device together with an endoscope, it is possible to stably perform imaging by the imaging unit and treatment by the treatment tool from different directions in the observation space, in addition to imaging by the imaging unit and treatment by the treatment tool provided on the endoscope. [Brief description of the drawings]

[0009] [Figure 1] 1 is a diagram showing an entire endoscope and an endoscope auxiliary device according to an embodiment of the present invention. [Diagram 2] 1 is a schematic diagram showing an endoscope auxiliary device including a distal end portion of an endoscope inserted into the large intestine and a first fixing mechanism. FIG. [Diagram 3] 11 is a schematic diagram illustrating a state until the endoscope auxiliary device is deployed. FIG. [Figure 4] 13 is a schematic diagram illustrating a coordinated treatment of an observation target and a state of extraction after the treatment. FIG. [Diagram 5] 13 is a schematic diagram illustrating another example of the configuration of the endoscope tip portion and the endoscope auxiliary device, and how they perform coordinated treatment. FIG. [Figure 6] 13 is a schematic diagram illustrating the configuration of yet another example of the endoscope tip portion and the endoscope auxiliary device, and the manner in which they perform coordinated treatment. FIG. [Figure 7] 5A and 5B are schematic diagrams illustrating a rotation mechanism of a support portion. [Figure 8] 1 is a schematic diagram showing an endoscope auxiliary device including a distal end portion of an endoscope inserted into the large intestine and a second fixing mechanism. FIG. [Figure 9] 11 is a schematic diagram illustrating a state until the endoscope auxiliary device is deployed. FIG. [Figure 10] 13 is a schematic diagram illustrating a coordinated treatment of an observation target and a state of extraction after the treatment. FIG. [Figure 11] 11 is a schematic diagram for explaining a state of coordinated treatment on an observation object when a plurality of stationary mechanisms are provided. FIG. [Figure 12] 1 is a schematic diagram showing an endoscope auxiliary device including a distal end portion of an endoscope inserted into the large intestine and a third fixing mechanism. FIG. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0010] With reference to the accompanying drawings, an embodiment of the present invention will be described. In each drawing, the same reference numerals are used to denote the same or similar configurations. In addition, when there are a plurality of structures having the same or similar configurations in each drawing, in order to avoid complication, some of the structures may be given reference numerals and the same reference numerals may not be used to denote the other structures. In addition, not all of the configurations described in the embodiment are necessarily essential as means for solving the problem.

[0011] 1 is a diagram showing the entirety of an endoscope 200 and an endoscope assist device 100 according to this embodiment. The endoscope assist device 100 according to this embodiment is attached to a tip portion 211 of an insertion tube 210 of the endoscope 200 when used. The endoscope assist device 100 is attached to the tip portion 211 at the start of use, and is located at the most distal end when inserted into a body cavity of a subject.

[0012] The endoscope 200 includes an insertion tube 210, a handle 220, an operation dial 231, an operation button 232, a cable 240, and an air port 250. The insertion tube 210 is flexible and is inserted into the body cavity of the subject by the doctor's manipulation, and serves the function of making the endoscope assist device 100 and the tip portion 211 reach the observation space in the body cavity. The handle 220 is a gripping portion that is held by the doctor, and an operation dial 231 and an operation button 232 are provided as operation members near the handle 220. By operating these operation members, the doctor operates the treatment tool and the camera unit provided at the tip portion 211, adjusts the orientation of the tip portion 211, and gives control instructions to the endoscope assist device 100.

[0013] The cable 240 is connected to the control unit and includes a signal line for transmitting image data captured by the camera unit provided on the tip portion 211 and the camera unit provided on the endoscope assist device 100 to the control unit. The control unit processes image data received from the endoscope 200 and the endoscope assist device 100 and displays the image data visibly on a display panel connected to the control unit. The cable 240 includes a power supply line for supplying power required by the endoscope 200 and the endoscope assist device 100. The air port 250 is connected to the compressor via an air tube and sends air taken in from the compressor toward the tip portion 211 or sucks air out from the tip portion 211 in response to the operation of the operating member by the doctor.

[0014] When the endoscope auxiliary device 100 attached to the tip 211 of the endoscope 200 reaches a target observation space in the body cavity of the subject, it is deployed and performs auxiliary operations for observation and treatment by the endoscope 200. The observation space is determined for each application of the endoscope, and may be, for example, an internal space of the esophagus, stomach, duodenum, small intestine, large intestine, bronchi, abdominal cavity, blood vessels, etc. The endoscope 200 in this embodiment is capable of observing and treating a target site in the internal space of the large intestine as an example, and the endoscope auxiliary device 100 will be described as being manufactured corresponding to the endoscope 200. The elements and configurations of the endoscope auxiliary devices attached to other types of endoscopes may be appropriately changed depending on the properties of the observation space and the target site, etc.

[0015] 2 is a schematic diagram showing the state of the endoscope assist device 100 including the tip 211 of the insertion tube 210 inserted into the internal space of the large intestine 910 and the balloon 111 which is the first fixing mechanism. Specifically, it is a bird's-eye view of a part cut out along the extension direction of the large intestine 910, and shows the state of observing a lesion 920 occurring on the inner wall surface 911 as a target site.

[0016] 2, the endoscope assist device 100 is in a separated state after being detached from the distal end portion 211 of the insertion tube 210. The endoscope assist device 100 mainly includes a balloon 111, a support portion 120, a camera unit 130, an LED 140, and a connecting member 160.

[0017] The balloon 111 functions as a fixing mechanism that fixes the endoscope assist device 100 in the observation space by unfolding and pressing against the inner wall surface 911 of the observation space. That is, the balloon 111 inflates in the observation space it reaches, thereby fixing the endoscope assist device 100 at a specific position in the large intestine 910. The balloon 111 is made of, for example, silicone rubber.

[0018] The support part 120 has a cylindrical shape with a diameter approximately equal to that of the tip part 211, and includes a mounting tube 150 at one end side facing the balloon 111, and a fitting ring 121 at the other end side facing the tip part 211. The support part 120 is hard enough not to be easily deformed, and is made of, for example, PEEK (Poly Ether Ether Ketone) resin, hard polyurethane, or polysulfone (Poly arylether-aryl sulfone). The mounting tube 150 has a cylindrical shape with a diameter smaller than that of the support part 120, and the balloon 111 is mounted so that the opening of the balloon 111 covers the outer diameter of the mounting tube 150 and elastically contacts it. After the endoscope assist device 100 is removed from the body cavity of the subject, the balloon 111 is removed from the mounting tube 150, and when the endoscope assist device 100 is used again, a new balloon 111 is mounted on the mounting tube 150. The mounting tube 150 has an air hole 151 inside, and when air is supplied from the air hole 151 into the observation space, the balloon 111 expands, and when air is sucked from the air hole 151, the balloon 111 contracts. Note that, in this embodiment, air is used as the fluid for expanding the balloon 111, but it is not limited to air, and other gases or liquids may be used.

[0019] The fitting ring 121 functions as a detachment mechanism for detaching the endoscope assist device 100 from the tip portion 211 in the observation space. Specifically, the fitting ring 121 has a cylindrical shape with a diameter smaller than the cylindrical diameter of the support portion 120, and the outer circumferential surface of the fitting ring 121 fits with the inner circumferential surface of the tip ring 212 provided at the tip portion 211 of the insertion tube 210, thereby mounting the endoscope assist device 100 to the tip portion 211. When the balloon 111 is inflated in the observation space and the insertion tube 210 is displaced in the removal direction with the endoscope assist device 100 installed at a specific position, the frictional force of the engagement is exceeded, and the tip ring 212 detaches from the fitting ring 121. That is, the endoscope assist device 100 detaches from the tip portion 211 of the endoscope 200.

[0020] In this embodiment, the fitting ring 121 is used as the detachment mechanism, but the mechanism for detaching the endoscope assist device 100 from the tip portion 211 is not limited to this. For example, a snap fit that is locked in the pushing direction but detached in the pulling direction may be used, or an electronic lock that maintains a locked state using electromagnetic force and releases the locked state when turned off may be used. In any case, any mechanism may be used as long as it can detach the endoscope assist device 100 from the tip portion 211 of the endoscope 200 in the observation space.

[0021] Even if the endoscope assist device 100 is detached from the tip portion 211, the connection member 160 maintains connection with the tip portion 211. The connection member 160 provides the freedom of movement so that the tip portion 211 of the insertion tube 210 can change its position and orientation relative to the fixed endoscope assist device 100, while preventing the endoscope assist device 100 from being left behind in the observation space after being detached from the tip portion 211. Therefore, a material having at least flexibility is used for the connection member 160. The connection member 160 is detachably attached to a connector (not shown) provided on the tip portion 211. The connection member 160 is firmly connected to such an extent that it will not be released even if the insertion tube 210 is displaced in the removal direction with the endoscope assist device 100 installed in the observation space.

[0022] In this embodiment, the balloon 111 requires air supply and suction, the camera unit 130 requires power supply and transmission and reception of image signals and control signals, and the LED 140 requires power supply. Therefore, the connection member 160 is configured to integrally include an air tube 161 and a communication cable 162. The air tube 161 is formed of a flexible material such as a vinyl tube. One end of the air tube 161 passes through the inside of the support portion 120 and is connected to the mounting tube 150 so that the circulating air can reach the air vent 151, and the other end is connected to an air tube in the insertion tube 210 (described later) via a connector provided at the tip portion 211. The communication cable 162 includes a signal wire for communication and a power supply wire for power supply, each of which is formed of a flexible material such as a twisted metal wire. One end of the signal wire is connected to each camera unit 130, and the other end is connected to the cable 240 via a connector (not shown) and the inside of the insertion tube 210. Similarly, one end of the power supply wire is connected to each of the camera unit 130 and the LED 140, and the other end is connected to the cable 240 via a connector (not shown) and the inside of the insertion tube 210.

[0023] The connecting member 160 may have elasticity in addition to flexibility. For example, if the air tube 161 has a bellows-shaped joint and the communication cable 162 is made of a flat spring or a coil spring, the connecting member 160 has elasticity in addition to flexibility. If the connecting member 160 has elasticity, the doctor can move the tip portion 211 of the insertion tube 210 more freely relative to the fixed endoscope assist device 100.

[0024] The camera units 130 and the LEDs 140 are devices installed on the support section 120, and a plurality of each are installed facing the inner wall surface 911. In this embodiment, since the support section 120 has a cylindrical shape as described above, the camera units 130 and the LEDs 140 are installed four by four at 90° intervals so as to face in the radial direction with respect to the central axis of the cylinder. The number of camera units 130 and the number of LEDs 140 to be installed are determined according to the respective imaging viewing angles and illumination angles, and are preferably determined so that the entire circumference can be observed and the entire circumference can be illuminated. Note that instead of installing a plurality of LEDs 140, a configuration in which a single LED illuminates the entire circumference using a light guide ring may be adopted. The image signal of the image captured by each camera unit 130 is transmitted to the control unit connected to the endoscope 200 via the communication cable 162. Note that the image signal transmitted to the control unit may be only the image signal captured by the designated camera unit 130.

[0025] As shown in the figure, when the balloon 111 is inflated and deployed, the support part 120 is supported by the balloon 111 as if floating in the air in the observation space without contacting or being too close to the inner wall surface 911 of the large intestine 910. When the support part 120 is supported by the balloon 111 in this manner, each camera unit 130 installed on the support part 120 in the radial direction is appropriately spaced from the inner wall surface 911, and each camera unit 130 can appropriately capture the opposing inner wall surface 911. In other words, since the inner wall surface 911 surrounding the support part 120 can be appropriately captured over the entire circumference, at least one camera unit 130 can capture the lesion 920. A doctor can estimate the position of the lesion 920 by checking which camera unit 130 is capturing the lesion 920.

[0026] The tip portion 211 of the endoscope 200 has a convex base material 213 on the inside of the tip ring 212, and in this embodiment, the base material 213 is provided with a camera unit 260 and an LED 270. An image signal of an image captured by the camera unit 260 is transmitted to a control unit connected to the endoscope 200 via a communication cable 162. The LED 270 illuminates the imaging range of the camera unit 260.

[0027] The tip 211 can be curved by a drive mechanism (not shown) in the extension direction of the insertion tube 210 to change the orientation of the camera unit 260. The doctor can manually displace the insertion tube 210 in the forward / backward direction within a range in which the connection member 160 is not fully extended, and adjust the orientation of the tip 211 by the drive mechanism, thereby disposing the camera unit 260 at an appropriate distance and orientation with respect to the lesion 920. In this operation, the position of the lesion 920 estimated from the image captured by the camera unit 130 of the endoscope assist device 100 serves as useful reference information.

[0028] The doctor can confirm the lesion 920 from the image from the camera unit 130 installed in the support portion 120 and the image from the camera unit 260 installed in the base material 213 of the tip portion 211. That is, the doctor can confirm the lesion 920 from two or more different viewpoints. Therefore, the doctor can observe the lesion 920 in more detail and make a more correct judgment about the lesion 920.

[0029] Next, a procedure will be described for observing and withdrawing the lesion 920 using the endoscope auxiliary device 100. Fig. 3 is a schematic diagram for explaining the state of the endoscope auxiliary device 100 until it is deployed.

[0030] 3(A) shows a state in which the insertion tube 210 is pushed into the large intestine 910 to search for a lesion 920. The endoscope assist device 100 is attached to the tip 211 of the insertion tube 210, and is positioned at the front of the insertion tube 210 to advance through the large intestine 910. At this time, the balloon 111 is attached to the mounting tube 150 in a deflated state. In addition, the LED 140 illuminates the inner wall surface 911, and each camera unit 130 captures images and sequentially transmits the image signals to the control unit.

[0031] Fig. 3(B) shows the state in which the balloon 111 is inflated after the lesion 920 to be observed is found. When the lesion 920 is found as shown in Fig. 3(A), the advancement of the insertion tube 210 is stopped within a range in which the lesion 920 can be captured by at least one camera unit 130, and the balloon 111 is inflated.

[0032] The internal space of the balloon 111 is connected to the air vent 151, air tube 161, and air tube 251, which are connected in series, and the balloon 111 is inflated by air supplied from the above-mentioned air port 250 being sent through these flow paths.

[0033] As the balloon 111 expands, its surface eventually comes into close contact with the inner wall surface 911 of the large intestine 910 over the entire circumferential direction, and as it expands further, it presses against the inner wall surface 911. When the balloon 111 presses against the inner wall surface 911, the supply of air is stopped and the expanded state is maintained. During the period in which this expanded state is maintained, the balloon 111, and therefore the entire endoscope assist device 100, is fixed in the observation space. In other words, it is possible to prevent the endoscope assist device 100 from easily moving from its fixed position in the large intestine 910.

[0034] Furthermore, as the balloon 111 expands, the support unit 120 is supported by the balloon 111 as if floating in the air in the observation space, as described above. Therefore, the device installed on the support unit 120 can stably act on the inner wall surface 911 of the observation space (in the case of the camera unit 130, the camera unit 130 can capture an image of the inner wall surface 911) by using the balloon 111 as a stationary mechanism as a foothold, so to speak.

[0035] 3(C) shows the state in which the endoscope assist device 100 is detached from the tip portion 211. As described above, when the balloon 111 is inflated and placed in the observation space, the endoscope assist device 100 cannot be moved by a small external force. When the doctor slightly pulls back the insertion tube 210 in this state, the engagement between the fitting ring 121 and the tip ring 212 is released, and the tip portion 211 is separated from the endoscope assist device 100. At this time, the connection member 160 that has been bent and pressed into the tip portion 211 or the fitting ring 121 is deployed.

[0036] When the tip 211 is separated from the endoscope assist device 100, the camera unit 260 is exposed in the observation space, and it is possible to start imaging by the camera unit 260. The doctor can observe the state of the separation of the endoscope assist device 100 from the image from the camera unit 260.

[0037] In an endoscope using an overtube, the endoscope auxiliary device is disposed in front of the tip of the endoscope and moved inside the overtube together with the tip of the endoscope, and is then pushed out from the end of the overtube, thereby detaching the endoscope auxiliary device from the endoscope. At this time, the overtube functions as a part of the detachment mechanism.

[0038] FIG. 4 is a schematic diagram for explaining the coordinated treatment of an observation object and the state of extraction after the treatment. FIG. 4(A) shows the state of observing a lesion 920 from multiple viewpoints as an example of the coordinated treatment of an observation object. It is substantially the same as the state shown in FIG. 2. As shown in the figure, of the multiple camera units 130 installed on the support part 120, the camera unit 130 facing upward captures the lesion 920. In addition, the tip 211 of the insertion tube 210 is slightly curved upward, so that the camera unit 260 captures the lesion 920 approximately in front. In other words, the lesion 920 is captured from different directions by the multiple camera units.

[0039] 4(B) shows the state in which the doctor has finished observing the lesion 920 and is withdrawing the insertion tube 210 and the endoscope assist device 100. After completing observation of the lesion 920, the doctor aspirates the air in the balloon 111 via the air tube 161. When the aspirating is completed, the balloon 111 shrinks and returns to the state shown in FIG. 3(A). Since the endoscope assist device 100 is connected to the tip 211 via the connecting member 160, when the doctor withdraws the insertion tube 210, the endoscope assist device 100 is also pulled out of the body.

[0040] Next, some other embodiments will be described which have different combinations of a treatment tool installed in the distal end portion 211 and a device installed in the support portion 120. Fig. 5 is a schematic diagram for explaining the configuration of such another embodiment (first modified example) and the state of the cooperative treatment.

[0041] In addition to the multiple camera units 130, the support section 120 according to the first modification is provided with a resection mechanism 170. The resection mechanism 170 includes an electric scalpel 171 that resects at least a portion of the lesion 920, and a movable arm 172 for moving the electric scalpel 171 closer to the lesion 920. The movable arm 172 is driven by an actuator (not shown), and can displace the electric scalpel 171 provided at the tip relative to the support section 120. Both the electric scalpel 171 and the actuator that drives the movable arm 172 are supplied with power via a power supply wire of the communication cable 162.

[0042] According to this configuration, the electric scalpel 171 is stably supported by the support portion 120 supported by the balloon 111, and can excise the lesion 920. In addition, since the lesion 920 can be observed from a plurality of viewpoints, particularly from a viewpoint (a viewpoint from the camera unit 260) different from the direction in which the electric scalpel 171 is extended, the doctor can appropriately perform treatment using the electric scalpel 171.

[0043] FIG. 6 is a schematic diagram for explaining the configuration of yet another embodiment (second modified example) and the state of the cooperative treatment. The support unit 120 according to the second modified example is provided with a traction mechanism 180 instead of the resection mechanism 170 of the first modified example. The traction mechanism 180 includes a clip 181 for pinching the lesion 920 and a traction arm 182 for pulling the clip 181. The traction arm 182 is driven by an actuator (not shown) and can pull the clip 181 provided at the tip toward the support unit 120. Both the clip 181 and the actuator for driving the traction arm 182 receive power via the power supply wire of the communication cable 162. A traction sensor, for example, a strain sensor, for measuring the traction force of the traction arm 182 may also be provided.

[0044] In addition to camera unit 260, forceps 280 are installed at tip portion 211. With this configuration, clip 181 is stably supported by support portion 120 supported by balloon 111 and can pull lesion 920. In particular, since lesion 920 can be pulled in a direction different from the direction in which forceps 280 is extended, incision treatment with forceps 280 can be performed significantly more easily and accurately.

[0045] Fig. 7 is a schematic diagram for explaining the rotation mechanism of the support part 120, which is an additional configuration of the second modified example described with reference to Fig. 6. As described above, the camera units 130 are arranged in a plurality of radial directions, so that they can capture images in all circumferential directions. However, it is difficult to arrange many traction mechanisms 180 (similar to the excision mechanism 170 of the first modified example described with reference to Fig. 5) on the support part 120. On the other hand, when one traction mechanism 180 is arranged, the directions in which the clip 181 and the traction arm 182 can be deployed are limited.

[0046] It is difficult to adjust the orientation of the support part 120 in advance when inflating the balloon 111. In other words, the direction in which the traction mechanism 180 faces relative to the support part 120 when the balloon 111 is inflated cannot be known until the balloon 111 is actually inflated. Therefore, it may occur that the clip 181 and the traction arm 182 cannot be deployed in the direction of the lesion 920 when the balloon 111 is inflated. Therefore, a rotation mechanism is added to the support part 120 as an additional configuration.

[0047] The rotation mechanism is a mechanism that provides a rotation ring 152 on the support part 120 and allows the support part 120 to rotate with respect to the balloon 111 by loosely fitting the rotation ring 152 with the mounting tube 150 for mounting the balloon 111. With such a rotation mechanism, as shown in the figure, when the forceps 280 installed on the tip part 211 grips and rotates the engagement ring 121 provided on the end of the support part 120, the support part 120 can be rotated around its central axis. That is, by controlling the operation of the forceps 280, the support part 120 can be rotated a predetermined amount and the clip 181 and the traction arm 182 can be adjusted to a position where they can be deployed in the direction of the lesion 920. Note that, here, a configuration in which the support part 120 is rotated using the forceps 280 has been described, but the tool for rotating the support part is not limited to the forceps 280, and any tool that can rotate the support part may be used. Furthermore, the configuration of the rotation mechanism is not limited to the above configuration, and any configuration may be used as long as the support portion can rotate relative to a fixed mechanism placed in the observation space.

[0048] In the present embodiment including the above-described modified examples, electronic devices such as sensors and actuators, including the camera unit 130, the LED 140, the resection mechanism 170, and the traction mechanism 180, have been described as devices to be installed on the support part 120. When installing such electronic devices on the support part 120, a configuration in which power is supplied via a power supply wire as described above, a configuration in which power is supplied from a secondary battery installed on the support part 120, or a configuration in which power is supplied wirelessly from outside the subject's body is adopted.

[0049] Instead of an electronic device, for example, a device driven by a fluid may be installed on the support portion 120. For example, a fluid actuator that deforms due to the flow of a fluid may be assumed. When such a device is adopted, the connection member 160 may be configured to include, as at least a part thereof, a tube for flowing the fluid to the device.

[0050] In the above embodiment, the balloon 111 has been described as the first fixing mechanism, but the fixing mechanism is not limited to the balloon 111. Fig. 8 is a schematic diagram showing the state of the endoscope auxiliary device 101 including the tip portion 211 of the insertion tube 210 inserted into the internal space of the large intestine 910 and the deployment cord 112 which is the second fixing mechanism. Specifically, it is the same as Fig. 2, and shows the state of observing a lesion 920 occurring on the inner wall surface 911 as a target site. The same components as those of the endoscope auxiliary device 100 shown in Fig. 2 are denoted by the same reference numerals, and description thereof will be omitted.

[0051] The endoscope auxiliary device 101 includes an unfolding cord 112. The unfolding cord 112 is a spirally wound wire-shaped member made of a temperature-responsive shape memory polymer (SMP). The temperature-responsive shape memory polymer is hard like plastic at temperatures lower than an adjusted glass transition temperature (e.g., 35°C), and when heated to the glass transition temperature or higher, it softens to a rubber-like shape and changes to a memorized shape. When it returns to a temperature lower than the glass transition temperature, it becomes hard like plastic while maintaining the memorized shape. The unfolding cord 112 is memorized so that the outer shape of the spiral expands when heated to the glass transition temperature or higher, and is adjusted to a size that presses the inner wall surface 911 of the large intestine 910 when the outer shape expands and is unfolded, as shown in FIG. 8.

[0052] In this embodiment, the deployment cord 112 incorporates a heating wire, which will be described later, as a core material, and when electricity is passed through the heating wire, the temperature of the SMP rises to or above the glass transition temperature, causing the SMP to deploy inside the large intestine 910. That is, like the balloon 111, the deployment cord 112 functions as a positioning mechanism that presses against the inner wall surface 911 of the observation space, thereby positioning the endoscope auxiliary device 101 in the observation space.

[0053] One end of the deployment cord 112 is attached to the mounting tube 150'. The mounting tube 150' has a cylindrical shape with a diameter smaller than that of the support part 120, and the deployment cord 112 is attached by pressing one end of the deployment cord 112 into a fitting hole provided in the center. After being removed from the subject's body cavity, the deployment cord 112 is removed from the mounting tube 150', and when the endoscope auxiliary device 100 is to be used again, a new deployment cord 112 is attached to the mounting tube 150'. In addition, a connector is provided in the fitting hole of the mounting tube 150', and when the deployment cord 112 is pressed into the fitting hole, the heating wire is connected to the high power supply cable 163.

[0054] The connecting member 160' is configured to integrally include a high power supply cable 163 instead of the air tube 161 compared to the connecting member 160 in the above embodiment. One end of the high power supply cable 163 is connected to the heating wire of the deployment cord 112 via a connector, and supplies the heating wire with enough power to generate heat. The other end is connected to the cable 240 via a connector (not shown) and the inside of the insertion tube 210. The connecting member 160' is flexible like the connecting member 160.

[0055] With this configuration, the doctor can freely move the tip 211 of the insertion tube 210 relative to the fixed endoscope assist device 101, similarly to the endoscope assist device 100 employing the balloon 111. Furthermore, since the fixing mechanism is configured in a spiral shape, it is expected that the breathability in the large intestine 910 is not blocked, and the burden on the subject is reduced. The balloon 111 of the endoscope assist device 100 may also be formed in a doughnut shape by providing a vent hole penetrating along the extension direction of the large intestine 910.

[0056] Next, a procedure will be described for observing the lesion 920 and then withdrawing it using the endoscope auxiliary device 101. Fig. 9 is a schematic diagram for explaining the state until the endoscope auxiliary device 101 is deployed.

[0057] 9(A) shows a state in which the insertion tube 210 is pushed into the large intestine 910 to search for a lesion 920. The endoscope assist device 101 is attached to the tip 211 of the insertion tube 210, and is positioned at the front of the insertion tube 210 to advance through the large intestine 910. At this time, the deployment cord 112 is attached to the mounting tube 150' in a contracted state. In addition, the LED 140 illuminates the inner wall surface 911, and each camera unit 130 captures images and sequentially transmits the image signals to the control unit.

[0058] 9(B) shows how the deployment cord 112 is deployed after the lesion 920 to be observed is found. When the lesion 920 is found as shown in FIG. 9(A), the forward movement of the insertion tube 210 is stopped within a range where the lesion 920 can be captured by at least one camera unit 130, and the deployment cord 112 is deployed.

[0059] The deployment cord 112 has a heating wire 113 as a core material. The heating wire 113 is made of, for example, a nichrome wire or a platinum wire, and is embedded along the extension direction of the SMP. The heating wire 113 communicates with a high-power supply cable 163, which is a part of the connection member, and a high-power supply cable 252 arranged inside the insertion tube 210, and generates heat when power is supplied from the outside through these cables.

[0060] When the temperature of the unfolding cord 112 is raised above the glass transition temperature by the heat generated by the heating wire 113, the unfolding cord 112 softens to a rubber-like state and expands into a spiral shape, and eventually the surface thereof comes into close contact with the inner wall surface 911 of the large intestine 910 over the entire outer periphery, and as it further expands, it presses against the inner wall surface 911. When the unfolding cord 112 presses against the inner wall surface 911, the supply of power is stopped, and when it returns to a temperature lower than the glass transition temperature by natural cooling, it returns to a plastic state and maintains its unfolded state while maintaining a certain degree of elasticity. During the period in which such an unfolded state is maintained, the unfolding cord 112, and in turn the entire endoscope auxiliary device 101, is fixed in the observation space. In other words, it is possible to prevent the endoscope auxiliary device 101 from easily moving from its fixed position in the large intestine 910.

[0061] Furthermore, as the deployment cords 112 deploy, the support section 120 is supported by the deployment cords 112 so as to float in the air in the observation space. Therefore, the device installed on the support section 120 can stably act on the inner wall surface 911 of the observation space by using the deployment cords 112 as a stationary mechanism, so to speak, as a foothold.

[0062] 9(C) shows the state in which the endoscope assist device 101 is detached from the tip portion 211. As described above, once the deployment cord 112 is deployed and placed in the observation space, the endoscope assist device 101 will not move even with a small external force. When the doctor slightly pulls back the insertion tube 210 in this state, the engagement between the fitting ring 121 and the tip ring 212 is released, and the tip portion 211 is separated from the endoscope assist device 101. At this time, the connection member 160' that has been bent and pressed into the tip portion 211 or the fitting ring 121 is deployed.

[0063] FIG. 10 is a schematic diagram for explaining the coordinated treatment of an observation object and the state of extraction after the treatment. FIG. 10(A) shows the state of observing a lesion 920 from multiple viewpoints as an example of the coordinated treatment of an observation object. It is substantially the same as the state shown in FIG. 8. As shown in the figure, among the multiple camera units 130 installed on the support part 120, the camera unit 130 facing upward captures the lesion 920. In addition, the tip 211 of the insertion tube 210 is slightly curved upward, so that the camera unit 260 captures the lesion 920 approximately in front. In other words, the lesion 920 is captured from different directions by the multiple camera units.

[0064] FIG. 10B shows the state where the observation of the lesion 920 is finished and the insertion tube 210 and the endoscope auxiliary device 101 are pulled out. After the observation of the lesion 920 is finished, the doctor pulls the insertion tube 210 so as to displace it beyond a predetermined amount larger than the length of the connection member 160'. The deployed deployment cord 112 cannot be displaced together with the insertion tube 210 due to frictional force generated between the deployment cord 112 and the inner wall surface 911, and the tensile force from the insertion tube 210 increases, causing the SMP to break. When the SMP breaks, small pieces generated by the breakage peel off from the inner wall surface 911. Since these small pieces are connected to each other by the heating wire 113, when the doctor pulls out the insertion tube 210, the deployment cord 112 is also dragged together with the support part 120 connected to the connection member 160' and is discharged outside the body. Alternatively, the deployment cord 112 may be heated again to above the glass transition temperature without breaking, and pulled out of the body in a state softened to a rubber-like state.

[0065] The material of the deployment cord 112 is not limited to SMP, and a temperature-responsive shape-memory alloy may be used. The element for heating the shape-memory polymer or shape-memory alloy is not limited to a heating wire. For example, a pipe may be provided inside to circulate hot water.

[0066] Also, although several embodiments have been described in which the combination of the treatment tool installed at the tip portion 211 and the device installed at the support portion 120 in the endoscope assist device 100 is different, these variations in combination can be similarly adopted in the endoscope assist device 101. Furthermore, when a fixing mechanism using the deployment cords 112 that do not block the air permeability inside the large intestine 910 is adopted, an endoscope assist device having a plurality of fixing mechanisms can also be envisioned.

[0067] 11 is a schematic diagram illustrating how an endoscope auxiliary device 102 equipped with a plurality of fixing mechanisms performs a coordinated treatment on an observation target. The endoscope auxiliary device 102 includes a support part 120a and a deployment cord 112a constituting a first fixing mechanism, and a support part 120b and a deployment cord 112b constituting a second fixing mechanism. The first fixing mechanism and the second fixing mechanism are respectively fixed at different positions in an observation space in the large intestine 910. For example, as shown in the figure, the first fixing mechanism is fixed in front of the lesion 920, and the second fixing mechanism is fixed behind the lesion 920. It is preferable that the support portion 120a of the first fixing mechanism and the support portion 120b of the second fixing mechanism face each other along the extension direction of the large intestine 910, and that the deployment cord 112a of the first fixing mechanism is deployed forward of the support portion 120a, and the deployment cord 112b of the second fixing mechanism is deployed rearward of the support portion 120b.

[0068] When the two fixed mechanisms are fixed in this manner, the lesion 920 can be captured by each of the camera units 130 installed on the support 120a and the camera units 130 installed on the support 120b. That is, the lesion 920 is captured from different directions by the multiple camera units. By increasing the number of fixed mechanisms, the camera units and treatment devices can be placed at more arbitrary positions in the observation space.

[0069] The distal end 211 of the insertion tube 210 can enter both the spiral interior of the unfolded deployment cord 112a and the spiral interior of the unfolded deployment cord 112b. For example, as shown in the figure, when the distal end 211 enters the spiral interior of the unfolded deployment cord 112b and is slightly curved upward, the lesion 920 can be grasped approximately in front. In this state, the doctor can operate the forceps 280 provided at the distal end 211 to appropriately treat the lesion 920 while maintaining a good field of vision.

[0070] In addition, when multiple stationary mechanisms are provided, the interconnections using the connecting members become complicated, so a configuration without the connecting members may be used. In that case, each stationary mechanism may be provided with a secondary battery corresponding to the required power, and a wireless unit for transmitting and receiving control signals and image signals.

[0071] In the above embodiment, the balloon 111 is described as the first fixing mechanism, and the deployment cord 112 is described as the second fixing mechanism, but a balloon that deploys in a spiral shape, which is a combination of these features, may be used as the fixing mechanism. FIG. 12 is a schematic diagram showing the state of the endoscope auxiliary device 103 including the tip portion 211 of the insertion tube 210 inserted into the internal space of the large intestine 910 and the spiral balloon 114, which is the third fixing mechanism. Specifically, it is the same as FIG. 2 and FIG. 8, and shows the state of observing the lesion 920 occurring on the inner wall surface 911 as the target site. The same reference numerals are used to denote the same components as the endoscope auxiliary device 100 shown in FIG. 2 and the endoscope auxiliary device 101 shown in FIG. 8, and the description thereof will be omitted.

[0072] The endoscope auxiliary device 103 includes a spiral balloon 114. The spiral balloon 114 is formed in a tube shape using, for example, silicone rubber, and is formed to draw a spiral shape when inflated by injecting air. An air port 153 for injecting air is provided at one end of the spiral balloon 114, and an end of an air tube 161 of a connecting member 160 is connected to the spiral balloon 114. Thus, like the balloon 111 used as the first fixing mechanism, the spiral balloon 114 inflates and develops in a spiral shape when air is supplied through the air tube 161, and the spiral outer shape expands and presses the inner wall surface 911. When the spiral balloon 114 presses the inner wall surface 911, the supply of air is stopped and the inflated state is maintained. During the period in which such an inflated state is maintained, the spiral balloon 114, and therefore the entire endoscope auxiliary device 103, is fixed in the observation space. That is, it is possible to prevent the endoscope auxiliary device 103 from easily moving from its fixed position in the large intestine 910. In this embodiment, air is used as the fluid for inflating the spiral balloon 114, but it is not limited to air, and other gases or liquids may also be used.

[0073] The spiral balloon 114 includes a flexible substrate 115 that is disposed on the inner periphery side when deployed. An end of a communication cable 162 of a connection member 160 is connected to the flexible substrate 115 near the airport port 153. The flexible substrate 115 includes a signal line for communication and a power supply line for power supply, similar to the communication cable 162.

[0074] The support 120' is disposed at a predetermined position on the flexible substrate 115. A plurality of support parts 120' may be disposed, and in this embodiment, two support parts 120' are disposed at a distance from each other. The support part 120' functions as a base member on which various devices can be disposed, similar to the above-mentioned support part 120. The support part 120' is hard enough not to be easily deformed, and is made of, for example, PEEK (Poly Ether Ether Ketone) resin, hard polyurethane, or polysulfone (Poly arylether-aryl sulfone). The support part 120' is electrically connected to a signal line and a power supply line at a part of the contact part that contacts the flexible substrate 115. The flexible substrate 115, by its adjusted shape and elasticity, defines the spiral shape of the spiral balloon 114 when air is injected, and defines the contracted and curled state when air is not injected. For such shape definition, the flexible substrate 115 may include a liquid crystal polymer (LCP) or a copper foil.

[0075] As shown in the figure, in this embodiment, each support 120' includes a camera unit 130 and an LED 140. The support 120' arranged inside the spiral in this manner allows the lesion 920 to be observed from various directions in conjunction with the camera unit 230 provided at the tip 211 of the endoscope 200. The support 120' may be provided with a traction mechanism 180 as described with reference to FIG. 6. By providing the traction mechanism 180, the direction in which the lesion 920 is towed can be adjusted in various ways. In addition, since the endoscope assist device 103 and the tip 211 of the endoscope 200 are connected by a flexible connecting member 160, the doctor can move the tip 211 of the insertion tube 210 more freely relative to the fixed endoscope assist device 103. The communication cable 162 may be a flexible substrate. When a flexible substrate is used, it may be folded in an accordion-like shape to increase flexibility.

[0076] The endoscope auxiliary device 103 is disposed in front of the tip portion 211 with the spiral balloon 114 in a deflated state, and is pushed forward by the insertion tube 210 through the inside of the overtube 290 inserted up to the vicinity of the observation space, and is pushed out from its end into the observation space. At this time, the endoscope auxiliary device 103 detaches from the tip portion 211, and the spiral balloon 114 becomes inflatable. Note that even when the spiral balloon 114 is employed, the endoscope auxiliary device 103 may be configured to include a detachment mechanism using a fitting ring 121 as in the endoscope auxiliary device 100, or another detachment mechanism.

[0077] In addition, in any of the above-described embodiments, the endoscope assist device can be operated through an operating member provided in the endoscope 200, and an example has been described in which an image signal received through the endoscope system is displayed on a display panel as a visible image. However, the system configuration is not limited to this, and an independent operation unit may be provided for the endoscope assist device, and transmission and reception of control signals including image signals may also be configured to be performed via an independent control unit. In this case, an image captured by the camera unit of the endoscope assist device may be displayed on a display panel connected to the control unit, or may be delivered to the endoscope system as an image signal.

[0078] In addition, the endoscope auxiliary device can be arranged in the observation space in various ways other than the above. For example, first, the insertion tube 210 is inserted into an overtube having a balloon at its tip, and the balloon is brought to the vicinity of the observation space while checking an image from a camera unit provided at the tip of the overtube. When the balloon reaches the vicinity of the observation space, the balloon is inflated to fix the overtube to the observation space. After that, the insertion tube 210 is temporarily removed. Then, the endoscope auxiliary device is packed into the overtube, and the insertion tube 210 is inserted into the overtube again by pushing the rear end. Eventually, the endoscope auxiliary device is pushed out from the end of the overtube on the observation space side and inserted into the observation space. The endoscope auxiliary device can also be arranged in the observation space by such a procedure. [Explanation of symbols]

[0079] 100, 101, 102, 103...endoscope auxiliary device, 111...balloon, 112, 112a, 112b...deployment cable, 113...heating wire, 114...spiral balloon, 115...flexible substrate, 120, 120a, 120b, 120'...support part, 121...fitting ring, 130...camera unit, 140...LED, 150, 150'...mounting tube, 151...ventilation hole, 152...rotating ring, 153...air port, 160, 160'...connecting member, 161...air tube, 162...communication cable, 163...high power supply cable, 170 ...Resection mechanism, 171...electric scalpel, 172...movable arm, 180...traction mechanism, 181...clip, 182...traction arm, 200...endoscope, 210...insertion tube, 211...tip, 212...tip ring, 213...base material, 220...handle, 231...operation dial, 232...operation button, 240...cable, 250...air port, 251...air tube, 252...high power supply cable, 260...camera unit, 270...LED, 280...forceps, 290...overtube, 910...large intestine, 911...inner wall surface, 920...lesion

Claims

1. An endoscope auxiliary device used in conjunction with a distal end of an endoscope, a detachment mechanism for detaching the endoscope assist device from the tip portion in an observation space of the endoscope; a fixing mechanism that, after being detached from the tip portion, is deployed and presses an inner wall surface of the observation space to fix the observation space; A support part supported by the stationary mechanism; A device mounted on the support; a supply mechanism for supplying energy to the device; An endoscope auxiliary device comprising:

2. The endoscope auxiliary device according to claim 1 , wherein the support portion is supported by the fixing mechanism so as not to come into contact with the inner wall surface when the fixing mechanism is deployed.

3. The endoscope auxiliary apparatus according to claim 2 , wherein a plurality of the devices are installed facing the inner wall surface.

4. The endoscope assist device according to claim 2 , wherein the orientation of the support portion can be adjusted by a tool provided at the tip of the endoscope.

5. A traction mechanism is provided on the support portion, The endoscope assist apparatus according to claim 1 , wherein the device includes an actuator that drives the traction mechanism.

6. A flexible connecting member is connected to the tip portion, The endoscope assistance device according to claim 1 , wherein the supply mechanism includes a power supply wire provided integrally with the connection member and through which power is supplied from the endoscope.

7. The endoscope auxiliary device according to claim 1 , wherein the stationary mechanism deploys in a spiral shape inside the observation space.

8. The endoscope auxiliary device according to claim 7, wherein the fixing mechanism is formed using a shape-memory material.

9. 9. The endoscope auxiliary device according to claim 8, wherein the shape-memory material breaks when the tip portion is displaced by a predetermined amount or more after deployment.

10. The endoscope auxiliary device according to claim 7 , wherein the fixing mechanism is deployed in a spiral shape when a fluid is introduced thereinto.

11. The endoscope auxiliary device according to claim 1 , comprising a plurality of the fixing mechanisms.

Images