Medical system

Abstract

The medical system comprises: a medical device comprising an insertion portion having a bending portion and a bending wire installed on the bending portion; and a driving device, which is connected to the medical device in a detachable manner, and bends the bending portion by electrically driving the bending wire, the bending wire having a first bending wire and a second bending wire, and when the medical device is not assembled on the driving device, the first bending wire and the second bending wire are mechanically connected to form a loop state, and when the medical device is assembled on the driving device, the first bending wire and the second bending wire are in an antagonistic state in which they are independently electrically driven.

Description

Technical Field

[0001] The present invention relates to a medical system equipped with an endoscope. This application claims priority based on U.S. Provisional Application No. 62 / 961,872, filed in the United States on January 16, 2020, and PCT Application No. PCT / JP2020 / 040874, filed on October 30, 2020, the contents of which are incorporated herein by reference. Background Art

[0002] Conventionally, endoscopes have been used for observation and treatment of luminal organs such as the digestive tract. A medical system that can more efficiently perform endoscopic observation and treatment is desired. For example, a medical system that can reduce fatigue for surgeons using endoscopes and is easy to use for even inexperienced surgeons is desired.

[0003] Patent Document 1 describes an electric bending endoscope having an insertion portion that is electrically driven to bend. The electric bending endoscope described in Patent Document 1 has an insertion portion that is electrically driven to bend, thereby reducing fatigue of the operator.

[0004] Prior art literature

[0005] Patent Literature

[0006] Patent Document 1: Japanese Patent No. 4823697 Summary of the Invention

[0007] Problems to be solved by the invention

[0008] Although the electric bending endoscope described in Patent Document 1 is a medical system that can reduce the fatigue of the surgeon to a certain extent by electrically driving the bending portion, the bending control portion equipped with a motor is held on the fixed arm of the endoscope, which sometimes interferes with the operation and is not always easy for the surgeon to use. It is not a medical system that can more effectively perform insertion observation or treatment.

[0009] In view of the above circumstances, an object of the present invention is to provide a medical system capable of more efficiently performing observation or treatment using an endoscope.

[0010] Means used to solve problems

[0011] In order to solve the above problems, the present invention proposes the following solutions.

[0012] The medical system of the first embodiment of the present invention comprises: a medical device, which includes an insertion portion having a bending portion and a bending wire installed on the bending portion; and a driving device, which is connected to the medical device in a detachable manner, and bends the bending portion by electrically driving the bending wire, the bending wire having a first bending wire and a second bending wire, and when the medical device is not assembled on the driving device, the first bending wire and the second bending wire are mechanically connected to form a ring state, and when the medical device is assembled on the driving device, the first bending wire and the second bending wire are in an antagonistic state of being independently electrically driven.

[0013] Effects of the Invention

[0014] According to the medical system of the present invention, observation or treatment using an endoscope can be performed more efficiently. BRIEF DESCRIPTION OF THE DRAWINGS

[0015] Figure 1 It is an overall view of the electric endoscope system according to the first embodiment.

[0016] Figure 2 1 is a diagram showing an endoscope and an operating device of the electric endoscope system used by a surgeon.

[0017] Figure 3 1 is a diagram showing an insertion portion of the endoscope.

[0018] Figure 4 This is a diagram showing a part of the bending portion of the endoscope as a cross-sectional view.

[0019] Figure 5 yes Figure 4 An enlarged view of the node ring of the bend in area E is shown.

[0020] Figure 6 It is along Figure 4 and Figure 5 A cross-sectional view of the curved portion taken along line C1-C1.

[0021] Figure 7 It is along Figure 4 A cross-sectional view of the curved portion (second curved portion) taken along line C2-C2.

[0022] Figure 8 It is a perspective view of the connecting portion of the endoscope.

[0023] Figure 9 This is a perspective view of a portion of the connecting portion.

[0024] Figure 10 is a cross-sectional view of the connecting portion.

[0025] Figure 11It is a perspective view of the cylindrical member and the bearing portion of the connection portion.

[0026] Figure 12 This is a diagram showing the first attachment and detachment portion before being attached to the driving device of the electric endoscope system.

[0027] Figure 13 This is a diagram showing the first upper and lower bending wire attachment and detachment portion before being attached to the drive device.

[0028] Figure 14 This is a diagram showing the first vertical bending wire attachment and detachment portion assembled to the drive device.

[0029] Figure 15 This is a functional block diagram of the drive device of the electric endoscope system.

[0030] Figure 16 This is a diagram showing the first vertical bending wire driving unit to which the first vertical bending wire attaching and detaching unit is attached.

[0031] Figure 17 It is a perspective view of the operating device of the electric endoscope system.

[0032] Figure 18 This is a perspective view of the operating device as seen from the back.

[0033] Figure 19 is a side view of the operating device.

[0034] Figure 20 It is a perspective view of the operating device with the second forceps jaw fixing device installed.

[0035] Figure 21 This is a functional block diagram of the control device of the electric endoscope system.

[0036] Figure 22 This is a functional block diagram of the main controller of the control device.

[0037] Figure 23 It is a perspective view of a modified example of the operating device.

[0038] Figure 24 It is a three-dimensional view of the operating device with the second forceps mouth fixing device installed at different positions.

[0039] Figure 25 It shows Figure 24 FIG. 1 is a diagram showing an example of use of the operating device.

[0040] Figure 26 It is an overall view of an electric endoscope system according to a second embodiment.

[0041] Figure 27 This is a functional block diagram of the drive device of the electric endoscope system.

[0042] Figure 28 This is a transition diagram of the bending mode of the bending portion in the electric endoscope system.

[0043] Figure 29 1 is a diagram showing a switching switch of an operating device in the electric endoscope system.

[0044] Figure 30 1 is a diagram showing the bending portion controlled in the coordinated bending control mode.

[0045] Figure 31 It is an overall view of an electric endoscope system according to a third embodiment.

[0046] Figure 32 This is a diagram showing the first attachment and detachment portion before being attached to the driving device of the electric endoscope system.

[0047] Figure 33 This is a diagram showing the first upper and lower bending wire attachment and detachment portion before being attached to the drive device.

[0048] Figure 34 This is a diagram showing the first vertical bending wire attachment and detachment portion assembled to the drive device.

[0049] Figure 35 This is the functional block diagram of the drive device.

[0050] Figure 36 This is a diagram showing the first vertical bending wire driving unit to which the first vertical bending wire attaching and detaching unit is attached.

[0051] Figure 37 1 and 2 are diagrams showing a usage example of the bending portion in the electric endoscope system.

[0052] Figure 38 It is an overall view of an electric endoscope system according to a fourth embodiment.

[0053] Figure 39 This is a perspective view of the cylindrical member and the bearing portion in the electric endoscope system.

[0054] Figure 40 It is an exploded perspective view of the cylindrical member and the bearing portion.

[0055] Figure 41 1 and 2 are diagrams illustrating treatment using the electric endoscope system.

[0056] Figure 42 1 and 2 are diagrams showing a modified example of the connecting portion of the electric endoscope system.

[0057] Figure 43 It is an overall view of an electric endoscope system according to a fifth embodiment.

[0058] Figure 44 This is a cross-sectional view of the soft part inside the body of the electric endoscope system.

[0059] Figure 45 This is a cross-sectional view of the external soft portion of the electric endoscope system.

[0060] Figure 46 FIG. 1 is a diagram showing two bundled wire sheaths.

[0061] Figure 47 It is a cross-sectional view of the curved internal soft part and the external soft part.

[0062] Figure 48 This is a diagram showing an insertion portion of the electric endoscope system inserted into the large intestine.

[0063] Figure 49 It is a diagram showing a modified example of the fastener.

[0064] Figure 50 It is a diagram showing a modified example of two-wire sheaths.

[0065] Figure 51 This is an overall diagram of a billing system including an electric endoscope system according to a sixth embodiment.

[0066] Figure 52 This is a flowchart showing the procedure of the processing for billing in the electric endoscope system.

[0067] Figure 53 This is a flowchart showing the procedure of the processing for billing in the electric endoscope system.

[0068] Figure 54 It is an overall view of an electric endoscope system according to a seventh embodiment.

[0069] Figure 55 1 is a flowchart showing the steps of a process for displaying a three-dimensional image in the electric endoscope system.

[0070] Figure 56 1 is a diagram showing the positional relationship between the endoscope and the display device in the electric endoscope system.

[0071] Figure 57 1 is a diagram showing the positional relationship between the endoscope and the display device in the electric endoscope system.

[0072] Figure 58 1 is a diagram showing an example of a three-dimensional image displayed on a display device in the electric endoscope system.

[0073] Figure 59 1 is a diagram showing an example of a three-dimensional image displayed on a display device in the electric endoscope system.

[0074] Figure 60 1 is a diagram showing the positional relationship among the operator, the endoscope, and the display device in the electric endoscope system.

[0075] Figure 61 1 is a diagram showing the positional relationship among the operator, the endoscope, and the display device in the electric endoscope system.

[0076] Figure 62 1 is a diagram showing the positional relationship among the operator, the endoscope, and the display device in the electric endoscope system.

[0077] Figure 63 1 is a diagram showing the relationship between the first direction and the second direction in the electric endoscope system.

[0078] Figure 64 1 is a diagram showing the relationship between the first direction and the second direction in the electric endoscope system.

[0079] Figure 65 1 is a diagram showing the relationship between the first direction and the second direction in the electric endoscope system.

[0080] Figure 66 1 and 2 are diagrams showing examples of images displayed on a display device in the electric endoscope system.

[0081] Figure 67 1 and 2 are diagrams showing examples of images displayed on a display device in the electric endoscope system.

[0082] Figure 68 1 and 2 are diagrams showing examples of images displayed on a display device in the electric endoscope system.

[0083] Figure 69 1 and 2 are diagrams showing examples of images displayed on a display device in the electric endoscope system.

[0084] Figure 70 1 and 2 are diagrams showing examples of images displayed on a display device in the electric endoscope system.

[0085] Figure 71 1 and 2 are diagrams showing examples of images displayed on a display device in the electric endoscope system.

[0086] Figure 72 1 and 2 are diagrams showing examples of images displayed on a display device in the electric endoscope system.

[0087] Figure 73 It is an overall view of an electric endoscope system according to an eighth embodiment.

[0088] Figure 741 is a top view of the electric endoscope system.

[0089] Figure 75 This is a control flow chart of the control device of the electric endoscope system.

[0090] Figure 76 It is an overall view of an electric endoscope system according to a ninth embodiment.

[0091] Figure 77 This is a functional block diagram of the drive device of the electric endoscope system.

[0092] Figure 78 1 is a diagram illustrating a restoring force acting on a bending portion in the electric endoscope system.

[0093] Figure 79 FIG. 1 is a diagram showing other frictional forces acting on the bending portion of the electric endoscope system.

[0094] Figure 80 : is a graph showing the relationship between the bending angle and the restoring force of the bending portion in the electric endoscope system.

[0095] Figure 81 This is a control flow chart of the control device of the electric endoscope system.

[0096] Figure 82 1 is a diagram showing a bending portion controlled by the control device.

[0097] Figure 83 1 is a diagram showing a bending portion controlled by the control device.

[0098] Figure 84 1 is a diagram showing a bending portion controlled by the control device.

[0099] Figure 85 1 is a diagram showing a bending portion controlled by the control device.

[0100] Figure 86 1 is a diagram showing a bending portion controlled by the control device.

[0101] Figure 87 1 is a diagram showing a bending portion controlled by the control device.

[0102] Figure 88 It is an overall view of an electric endoscope system according to a tenth embodiment.

[0103] Figure 89 It is a perspective view of the operating device of the electric endoscope system.

[0104] Figure 90 is a side view of the operating device with the touch panel set to the first mode.

[0105] Figure 91 is a side view of the operating device with the touch panel set to the second mode.

[0106] Figure 92 It is a perspective view showing a modified example of the operating device.

[0107] Figure 93 It is an overall view of an electric endoscope system according to an eleventh embodiment.

[0108] Figure 94 It is a perspective view of the operating device of the electric endoscope system.

[0109] Figure 95 It is an overall view of an electric endoscope system according to a twelfth embodiment.

[0110] Figure 96 This is a perspective view of the operating device as seen from the back.

[0111] Figure 97 This is a three-dimensional view of the operating device installed on the soft part outside the body.

[0112] Figure 98 This is a diagram illustrating how to use the electric endoscope system.

[0113] Figure 99 1 and 2 are diagrams showing different ways of mounting the mounting adapter of the operating device.

[0114] Figure 100 1 and 2 are diagrams showing a modified example of the operating device. DETAILED DESCRIPTION

[0115] (First embodiment)

[0116] Reference Figures 1 to 25 An electric endoscope system 1000 according to a first embodiment of the present invention will be described. Figure 1 It is an overall view of the electric endoscope system 1000 according to this embodiment.

[0117] [Electric Endoscope System 1000]

[0118] like Figure 1 As shown, the electric endoscope system 1000 is a medical system for observing and treating the body of a patient P lying on an operating table T. The electric endoscope system 1000 includes an endoscope 100 , a driving device 200 , an operating device 300 , a treatment instrument 400 , an image control device 500 , and a display device 900 .

[0119] An endoscope 100 is a device that is inserted into the lumen of a patient P to observe and treat an affected area. The endoscope 100 and the drive unit 200 are removable. An internal path 101 is formed within the endoscope 100. In the following description, the side of the endoscope 100 that is inserted into the lumen of the patient P is referred to as the "distal end (A1)," and the side that is attached to the drive unit 200 is referred to as the "proximal end (A2)."

[0120] The drive device 200 is detachably connected to the endoscope 100 and the operating device 300. Based on an operation input to the operating device 300, the drive device 200 drives a built-in motor to electrically drive the endoscope 100. Furthermore, based on an operation input to the operating device 300, the drive device 200 drives a built-in pump and the like to cause the endoscope 100 to perform air supply and suction.

[0121] The operating device 300 is detachably connected to the driving device 200 via an operating cable 301. The operating device 300 can communicate with the driving device 200 via wireless communication rather than wired communication. The surgeon S can electrically drive the endoscope 100 by operating the operating device 300.

[0122] The treatment instrument 400 is a device that is inserted through the internal path 101 of the insertion endoscope 100 and into the lumen of the patient P to treat the affected part. Figure 1 In FIG, the treatment instrument 400 is inserted into the internal path 101 of the endoscope 100 via the extension channel tube 130. The treatment instrument 400 may be directly inserted into the internal path 101 of the endoscope 100 from the forceps port 126 without passing through the extension channel tube 130.

[0123] The image control device 500 is detachably connected to the endoscope 100 and acquires a captured image from the endoscope 100. The image control device 500 displays the captured image, a GUI image, and a CG image on the display device 900. The captured image is acquired from the endoscope 100, and the GUI image and CG image are intended to provide information to the operator.

[0124] The driving device 200 and the image control device 500 constitute a control device 600 for controlling the electric endoscope system 1000. The control device 600 may further include peripheral devices such as a video printer. The driving device 200 and the image control device 500 may also be an integrated device.

[0125] The control device 600 can be connected to the hospital network and can obtain information such as electronic medical records from the server. In addition, the control device 600 can also be connected to the Internet and can perform maintenance of the endoscope 100 via the Internet.

[0126] The display device 900 is a device capable of displaying images, such as an LCD, and is connected to the image control device 500 via a display cable 901 .

[0127] Figure 2 1 is a diagram showing an endoscope 100 and an operating device 300 used by a surgeon S.

[0128] For example, the surgeon S operates the endoscope 100 inserted into the lumen of the patient P through the anus with his right hand R while observing the captured image displayed on the display device 900, and operates the operating device 300 with his left hand L. Since the endoscope 100 and the operating device 300 are separate, the surgeon S can operate the endoscope 100 and the operating device 300 independently without affecting each other.

[0129] [Endoscope 100]

[0130] like Figure 1 As shown, the endoscope 100 includes an insertion portion 110, a connecting portion 120, an external soft portion 140, a detachable portion 150, and a bending wire 160 (see FIG. Figure 6 ) and built-in 170 (refer to Figure 6 The insertion portion 110 , the connection portion 120 , the external soft portion 140 , and the attachment / detachment portion 150 are connected in sequence from the distal end side. The connection portion 120 can be connected to the extension channel tube 130 .

[0131] Figure 3 1 is a diagram showing the insertion portion 110 of the endoscope 100 .

[0132] The endoscope 100 includes an internal path 101 extending from the distal end of the insertion portion 110 to the proximal end of the attachment portion 150 along the longitudinal direction A of the endoscope 100 . The bending wire 160 and the internal object 170 are inserted into the internal path 101 .

[0133] The built-in object 170 has a channel tube 171 and an air supply and suction tube 172 (see Figure 10 ), camera cable 173 and light guide 174.

[0134] [Insertion section 110]

[0135] The insertion portion 110 is a long, thin member that can be inserted into a lumen. The insertion portion 110 includes a distal end portion 111, a curved portion 112, and an internal flexible portion 119. The distal end portion 111, the curved portion 112, and the internal flexible portion 119 are connected in sequence from the distal end side.

[0136] like Figure 3As shown in FIG. 1 , the front end portion 111 includes an opening 111a, an illumination portion 111b, and an imaging portion 111c. The opening 111a is an opening that communicates with the channel tube 171. Figure 3 As shown, a treatment portion 410 such as a grasping forceps provided at the distal end of a treatment instrument 400 inserted through the channel tube 171 is protruded from the opening 111 a .

[0137] The illumination unit 111b is connected to a light guide 174 for guiding illumination light, and emits illumination light for illuminating the imaging subject. The imaging unit 111c includes an imaging element such as a CMOS, and is used to capture the imaging subject. The imaging signal is sent to the image control device 500 via the imaging cable 173.

[0138] Figure 4 This is a diagram showing a part of the bent portion 112 as a cross-sectional view.

[0139] The bending portion 112 includes a first bending portion 113 on the distal end side of the bending portion 112, a second bending portion 114 on the proximal end side of the bending portion 112, and an outer sheath 118 (see FIG. Figure 3 The first curved portion 113 and the second curved portion 114 can be bent in different directions.

[0140] The first bending portion (front-end bending portion) 113 includes a plurality of node rings (also referred to as bending pieces) 115 and a first front end portion 116 connected to the front ends of the plurality of node rings 115. The plurality of node rings 115 and the first front end portion 116 are connected in the longitudinal direction A inside the outer sheath 118. The shape and number of the node rings 115 included in the first bending portion 113 are not limited to Figure 4 The shape and number of node rings 115 are shown.

[0141] Figure 5 yes Figure 4 An enlarged view of the node ring 115 in area E is shown.

[0142] The node ring 115 is a short cylindrical member formed of metal. The plurality of node rings 115 are connected so that the internal spaces of adjacent node rings 115 form a continuous space.

[0143] The node ring 115 includes a first node ring 115a at the distal end and a second node ring 115b at the proximal end. The first node ring 115a and the second node ring 115b are connected by a first rotation pin 115q so as to be rotatable about a rotation axis extending in a vertical direction (also referred to as the "UD direction") perpendicular to the longitudinal direction A.

[0144] In adjacent node rings 115, the second node ring 115b in the node ring 115 on the front end side and the first node ring 115a in the node ring 115 on the base end side are connected by a second rotating pin 115p in a manner that allows them to rotate around a rotation axis extending in the left-right direction (also called the "LR direction") perpendicular to the longitudinal direction A and the UD direction.

[0145] The first nodal ring 115 a and the second nodal ring 115 b are alternately connected by the first rotation pin 115 q and the second rotation pin 115 p , so that the bending portion 112 is bendable in a desired direction.

[0146] Figure 6 It is along Figure 4 and Figure 5 1 is a cross-sectional view of the curved portion 112 taken along line C1-C1.

[0147] An upper thread guide 115u and a lower thread guide 115d are formed on the inner circumference of the second nodal ring 115b. The upper thread guide 115u and the lower thread guide 115d are arranged on opposite sides of the longitudinal axis O in the UD direction. A left thread guide 115l and a right thread guide 115r are formed on the inner circumference of the first nodal ring 115a. The left thread guide 115l and the right thread guide 115r are arranged on opposite sides of the longitudinal axis O in the LR direction.

[0148] Through holes through which the bending wire 160 is inserted are formed along the longitudinal direction A in the upper wire guide 115u, the lower wire guide 115d, the left wire guide 115l, and the right wire guide 115r.

[0149] The second curved portion (proximal curved portion) 114 includes a plurality of node rings (also called curved pieces) 115 and a second distal end portion 117 connected to the distal ends of the node rings 115. The node rings 115 and the second distal end portion 117 are connected within an outer sheath 118 in the longitudinal direction A. The second distal end portion 117 is connected to the node ring 115 at the proximal end of the first curved portion 113. The node ring 115 at the proximal end of the second curved portion 114 is attached to the distal end of the internal soft portion 119.

[0150] The length of the first curved portion 113 in the longitudinal direction A is shorter than the length of the second curved portion 114 in the longitudinal direction A. Even if the bending angle is the same, the shorter the length of the curved portion in the longitudinal direction A is, the higher the front end precision is. By making the length of the first curved portion 113 in the longitudinal direction A shorter than the curved portion of an existing conventional endoscope, the front end portion 111 can be moved more accurately. Therefore, the front end side of the curved portion 112 can be bent more precisely. The ratio of the length of the first curved portion 113 in the longitudinal direction A to the length of the second curved portion 114 in the longitudinal direction A is, for example, 2:3 to 1:4. In addition, the shape and number of the node ring 115 of the second curved portion 114 are not limited to Figure 4 The shape and number of node rings 115 are shown.

[0151] The bending line 160 is a line for bending the bending portion 112. The bending line 160 includes a first bending line 161 for bending the first bending portion 113 and a second bending line 162 for bending the second bending portion 114. The first bending line 161 and the second bending line 162 extend through the internal path 101 to the attachment / detachment portion 150.

[0152] like Figure 4 and Figure 6 As shown, the first bending wire 161 includes a first upper bending wire 161u, a first lower bending wire 161d, a first left bending wire 161l, a first right bending wire 161r, and four first wire sheaths 161s.

[0153] like Figure 4 and Figure 7 As shown, the first upper bending wire 161u, the first lower bending wire 161d, the first left bending wire 161l, and the first right bending wire 161r are respectively inserted through the first wire sheath 161s. The front end of the first wire sheath 161s is attached to the second front end portion 117. The first wire sheath 161s extends to the attachment and detachment portion 150.

[0154] The first upper bending line 161u and the first lower bending line 161d are lines that bend the first bending portion 113 in the UD direction. The first upper bending line 161u is inserted through the upper wire guide 115u. The first lower bending line 161d is inserted through the lower wire guide 115d.

[0155] like Figure 4 As shown, the front ends of the first upper bending line 161u and the first lower bending line 161d are fixed to the first front end portion 116 at the front end of the first bending portion 113. The front ends of the first upper bending line 161u and the first lower bending line 161d fixed to the first front end portion 116 are arranged on both sides of the central axis O in the longitudinal direction A.

[0156] The first left bending wire 1611 and the first right bending wire 161r are wires that bend the first bending portion 113 in the LR direction. The first left bending wire 1611 is inserted through the left wire guide 1151. The first right bending wire 161r is inserted through the right wire guide 115r.

[0157] like Figure 4 As shown, the front ends of the first left bend line 1611 and the first right bend line 161r are fixed to the first front end portion 116 of the first bend portion 113. The front ends of the first left bend line 1611 and the first right bend line 161r fixed to the first front end portion 116 are arranged on both sides of the center axis O in the longitudinal direction A.

[0158] The first bending portion 113 is bendable in a desired direction by pulling or loosening the first bending wires 161 (the first upper bending wire 161u, the first lower bending wire 161d, the first left bending wire 161l, and the first right bending wire 161r).

[0159] Figure 7 It is along Figure 4 1 is a cross-sectional view of the second curved portion 114 taken along line C2-C2.

[0160] like Figure 4 and Figure 7 As shown, the second bending wire 162 includes a second upper bending wire 162u, a second lower bending wire 162d, a second left bending wire 162l, a second right bending wire 162r, and four second wire sheaths 162s.

[0161] like Figure 4 As shown, the second upper bending wire 162u, the second lower bending wire 162d, the second left bending wire 162l, and the second right bending wire 162r are each inserted through the second wire sheath 162s. The distal end of the second wire sheath 162s is attached to the node ring 115 at the base end of the second bending portion 114. The second wire sheath 162s extends to the attachment and detachment portion 150.

[0162] The second upper bending line 162u and the second lower bending line 162d are lines that bend the second curved portion 114 in the UD direction. Figure 7 As shown, in the second curved portion 114, the second upper curved wire 162u is inserted through the upper wire guide 115u. In addition, in the second curved portion 114, the second lower curved wire 162d is inserted through the lower wire guide 115d.

[0163] like Figure 4As shown, the front ends of the second upper and lower curve lines 162u and 162d are fixed to the second front end portion 117 at the front end of the second curved portion 114. The front ends of the second upper and lower curve lines 162u and 162d fixed to the second front end portion 117 are arranged on both sides of the center axis O in the longitudinal direction A.

[0164] The second left bending line 1621 and the second right bending line 162r are lines that bend the second bending portion 114 in the LR direction. Figure 7 As shown, in the second curved portion 114, the second left curved wire 1621 is inserted through the left wire guide 1151. In addition, in the second curved portion 114, the second right curved wire 162r is inserted through the right wire guide 115r.

[0165] like Figure 4 As shown, the front ends of the second left bend wire 162l and the second right bend wire 162r are fixed to the second front end portion 117 at the front end of the second bend portion 114. The front ends of the second left bend wire 162l and the second right bend wire 162r fixed to the second front end portion 117 are arranged on opposite sides of the center axis O in the longitudinal direction A.

[0166] The second bending portion 114 is bendable in a desired direction by pulling or loosening the second bending wires 162 (the second upper bending wire 162u, the second lower bending wire 162d, the second left bending wire 162l, and the second right bending wire 162r).

[0167] like Figure 6 and Figure 7 As shown, a bending wire 160 , a channel tube 171 , an imaging cable 173 , and a light guide 174 are inserted through the internal path 101 formed inside the bending portion 112 .

[0168] The internal soft part 119 is a long and flexible tubular member. A bending wire 160, a channel tube 171, an imaging cable 173, and a light guide 174 are inserted through the internal path 101 formed in the internal soft part 119.

[0169] [Connection 120]

[0170] Figure 8 It is a perspective view of the connecting portion 120 . Figure 9 It is a perspective view of a portion of the connecting portion 120 . Figure 10 It is a cross-sectional view of the connection portion 120 .

[0171] The connecting portion 120 connects the internal soft portion 119 and the external soft portion 140 of the insertion portion 110 . The connecting portion 120 includes a cylindrical member 121 , a connecting portion body 122 , a sealing portion 123 , a bearing 124 , a cover member 125 , a forceps opening 126 , and a three-pronged pipe 127 .

[0172] The cylindrical member 121 is formed into a cylindrical shape. Figure 10 As shown, the interior space of cylindrical member 121 communicates with the interior space of internal soft portion 119, forming a portion of internal path 101. Bend wire 160, channel tube 171, camera cable 173, and light guide 174 are inserted through the interior space of cylindrical member 121. A magnetic ring 121s is attached to the outer circumference of cylindrical member 121 along the circumferential direction.

[0173] The connecting portion body 122 is formed into a substantially cylindrical shape. Figure 10 As shown, the connecting portion body 122 has a front end 122a and a base end 122b. The base end 121b of the cylindrical member 121 is inserted into the front end opening of the front end 122a. The front end 140a of the external flexible portion 140 is bonded to the base end 122b using an adhesive, heat fusion, or other method. The interior space of the connecting portion body 122 communicates with the interior space of the external flexible portion 140, forming a portion of the internal path 101.

[0174] The sealing portion 123 includes a housing 123h and a ring 123r. The inner side of the housing 123h is fixed to the outer periphery of the cylindrical member 121. The outer side of the housing 123h contacts the inner peripheral surface of the front end portion 125a of the cover member 125 via the ring 123r.

[0175] Figure 11 It is a perspective view of the cylindrical member 121 and the bearing portion 124 .

[0176] The bearing 124 connects the connecting portion body 122 and the cylindrical member 121 so as to be rotatable about a rotation axis extending along the longitudinal direction A. Specifically, the bearing 124 is fixed to the connecting portion body 122. The bearing 124 supports the cylindrical member 121 so as to be rotatable about the rotation axis extending along the longitudinal direction A.

[0177] The connection body 122 includes a magnetic sensor (not shown) for detecting the rotation of the magnetic ring 121s, and can detect the rotation angle of the cylindrical member 121 relative to the connection body 122. The detected rotation angle is transmitted to the control device 600 via a transmission cable (not shown).

[0178] The base end portion 119 b of the internal flexible portion 119 is fixed to the outside of the outer shell 123 h . Therefore, the internal flexible portion 119 , the outer shell 123 h , and the cylindrical member 121 are integrated and rotate relative to the connecting portion main body 122 .

[0179] The cover member 125 covers the outer periphery of the connecting portion body 122. The cover member 125 has a first opening 125b through which the external flexible portion 140 passes, and a second opening 125c through which the forceps opening 126 passes. The gap between the first opening 125b and the external flexible portion 140 is sealed by a sealing member. The gap between the second opening 125c and the forceps opening 126 is also sealed by a sealing member.

[0180] The forceps opening 126 is an insertion opening for inserting the treatment instrument 400. The forceps opening 126 is formed into a cylindrical shape and is attached to the cover member 125. The base end portion 126b of the forceps opening 126 protrudes from the second opening 125c of the cover member 125. The extension channel tube 130 (see FIG. 130 ) can be connected to the base end portion 126b of the forceps opening 126. Figure 1 ).

[0181] The three-pronged branch tube 127 connects the proximal end 171b of the channel tube 171, the distal end 126a of the forceps jaws 126, and the distal end 172a of the air supply and suction tube 172. The channel tube 171 and the air supply and suction tube 172 are connected via the three-pronged branch tube 127. Furthermore, the forceps jaws 126 and the channel tube 171 are connected via the three-pronged branch tube 127. The surgeon S can insert the treatment instrument 400 from the proximal end 126b of the forceps jaws 126, thereby inserting the treatment instrument 400 through the channel tube 171.

[0182] The internal soft part 119 and the external soft part 140 are connected by the connecting part 120 so as to be rotatable around a rotation axis extending along the longitudinal direction A. Figure 2 As shown, when the surgeon S rotates the internal flexible portion 119 of the insertion portion 110 about the rotation axis extending along the longitudinal direction A, the surgeon S can rotate only the internal flexible portion 119 without rotating the external flexible portion 140 extending near the driving device 200. Therefore, the surgeon S can easily perform the rotation operation on the internal flexible portion 119.

[0183] On the other hand, frictional force is generated when the internal flexible portion 119 and the external flexible portion 140 rotate relative to each other, so relative rotation is prevented unless a force exceeding a predetermined value is applied. This frictional force is adjusted so that the internal flexible portion 119 does not rotate relative to the external flexible portion 140 unless the surgeon S rotates the internal flexible portion 119 of the insertion portion 110. Therefore, even if the surgeon S removes his right hand R from the internal flexible portion 119 to operate the treatment instrument 400, the internal flexible portion 119 does not rotate relative to the external flexible portion 140.

[0184] Furthermore, when the surgeon S rotates the internal soft portion 119 of the insertion portion 110 about the rotation axis extending along the longitudinal direction A, the forceps opening 126 attached to the connecting portion main body 122, which is a portion that does not rotate in conjunction with the internal soft portion 119, does not rotate. Since the position of the forceps opening 126 for inserting the treatment instrument 400 does not change, the surgeon S can easily operate the treatment instrument 400.

[0185] The base end portion 121b of the cylindrical member 121 is inserted into the interior of the connecting portion body 122. Therefore, the bending wire 160 and other components inserted through the cylindrical member 121 and the connecting portion body 122 primarily pass through the interior space of the cylindrical member 121 and are less likely to come into contact with the connecting portion body 122, which rotates relative to the cylindrical member 121. Therefore, even when the cylindrical member 121 and the connecting portion body 122 rotate relative to each other, the bending wire 160 and other components twist within the entire long internal path 101, thus reducing the concentration of torsional stress.

[0186] [External soft part 140]

[0187] The external flexible part 140 is a long tubular member. The bending wire 160, the camera cable 173, the light guide 174 and the air supply and suction tube 172 are inserted through the internal path 101 formed inside the external flexible part 140 (see Figure 10 ).

[0188] [Loading and unloading section 150]

[0189] like Figure 1 As shown, the attachment unit 150 includes a first attachment unit 1501 attached to the driving device 200 and a second attachment unit 1502 attached to the image control device 500. Alternatively, the first attachment unit 1501 and the second attachment unit 1502 may be an integrated attachment unit.

[0190] The internal path 101 formed inside the external flexible portion 140 branches into the first detachable portion 1501 and the second detachable portion 1502. The bending wire 160 and the air supply and suction tube 172 are inserted through the first detachable portion 1501. The imaging cable 173 and the light guide 174 are inserted through the second detachable portion 1502.

[0191] Figure 12 This is a diagram showing the first attachment / detachment portion 1501 before being attached to the drive device 200 .

[0192] The first attaching and detaching portion 1501 includes a first vertical bending wire attaching and detaching portion 151 , a first horizontal bending wire attaching and detaching portion 152 , a second vertical bending wire attaching and detaching portion 153 , and a second horizontal bending wire attaching and detaching portion 154 .

[0193] The first upper and lower bending wire detachable portion 151 is a mechanism that detachably connects wires (the first upper bending wire 161 u and the first lower bending wire 161 d ) for bending the first bending portion 113 in the UD direction to the driving device 200 .

[0194] The first left-right bending wire detachable portion 152 is a mechanism that detachably connects the wires (the first left bending wire 161 l and the first right bending wire 161 r ) that bend the first bending portion 113 in the LR direction to the driving device 200 .

[0195] The second upper and lower bending wire detachable portion 153 is a mechanism that detachably connects the wires (the second upper bending wire 162 u and the second lower bending wire 162 d ) for bending the second bending portion 114 in the UD direction to the driving device 200 .

[0196] The second left-right bending wire detachable portion 154 is a mechanism that detachably connects the wires (the second left bending wire 1621 and the second right bending wire 162r ) for bending the second bending portion 114 in the LR direction to the drive device 200 .

[0197] The first left-right bending wire detachable portion 152 , the second up-down bending wire detachable portion 153 , and the second left-right bending wire detachable portion 154 have the same structure as the first up-down bending wire detachable portion 151 , and therefore, illustration and description thereof are omitted.

[0198] Figure 13 This is a diagram showing the first vertical bending wire attaching and detaching portion 151 before being attached to the driving device 200 . Figure 14 15 is a diagram showing the first vertical bending wire detachable portion 151 attached to the driving device 200. The first vertical bending wire detachable portion 151 includes a supporting member 155, a rotating drum 156, and a tension sensor 159.

[0199] The support member 155 supports the rotating drum 156. The support member 155 includes an attachment and detachment detection protrusion 155a exposed on the base end side of the first vertical bending wire attachment and detachment portion 151, and a plurality of bend rollers 155p.

[0200] The turning wheel 155p changes the conveying direction of the first upper curved wire 161u passing through the flexible portion 140 inserted outside the body, and guides the first upper curved wire 161u to the rotating drum 156. The turning wheel 155p also changes the conveying direction of the first lower curved wire 161d passing through the flexible portion 140 inserted outside the body, and guides the first lower curved wire 161d to the rotating drum 156.

[0201] The rotating drum 156 is supported by the supporting member 155 so as to be rotatable around a drum rotating shaft 156 r extending in the longitudinal direction A. The rotating drum 156 includes a winding wheel 156 a and a coupling portion 156 c.

[0202] The winding wheel 156a rotates about the drum rotation axis 156r, thereby pulling or feeding out the first upper bending wire 161u and the first lower bending wire 161d. When the winding wheel 156a rotates clockwise (as viewed from the distal end toward the proximal end), the first upper bending wire 161u is wound around the winding wheel 156a and pulled, while the first lower bending wire 161d is fed from the winding wheel 156a. Conversely, when the winding wheel 156a rotates counterclockwise, the first upper bending wire 161u is fed from the winding wheel 156a, while the first lower bending wire 161d is wound around the winding wheel 156a and pulled.

[0203] The diameters of the portions of the first upper and lower bending wires 161u and 161d wound around the winding wheel 156a are larger than the diameters of the other portions. Therefore, the first upper and lower bending wires 161u and 161d can be appropriately prevented from being caught between the winding wheel 156a and the support member 155. Furthermore, the first upper and lower bending wires 161u and 161d can be appropriately prevented from stretching due to traction or relaxation.

[0204] The first upper bending wire 161u and the first lower bending wire 161d may have a larger diameter at the portion passing through the flexible portion 140 outside the body than at the portion passing through the insertion portion 110. This allows the insertion portion 110 to be thinner when inserted into the body. Furthermore, by making the diameter of the portion passing through the body thicker, the extension of the first upper bending wire 161u and the first lower bending wire 161d can be suppressed, thereby improving the controllability of the bending operation of the bending portion 112.

[0205] The coupling portion 156c is a circular plate member that rotates around the roller rotation axis 156r. The coupling portion 156c is fixed to the base end of the winding wheel 156a and rotates integrally with the winding wheel 156a. The coupling portion 156c is exposed at the base end of the first upper and lower bending wire attachment and detachment portion 151. Two interlocking protrusions 156d are formed on the base end of the coupling portion 156c. The two interlocking protrusions 156d are formed on either side of the roller rotation axis 156r.

[0206] The tension sensor 159 detects the tension of the first upper bending wire 161 u and the first lower bending wire 161 d . The detection result of the tension sensor 159 is acquired by the drive controller 260 .

[0207] [Drive device 200]

[0208] Figure 15 2 is a functional block diagram of the driving device 200 .

[0209] The driving device 200 includes an adapter 210 , an operation receiving unit 220 , an air supply and suction driving unit 230 , a wire driving unit 250 , and a driving controller 260 .

[0210] like Figure 12 As shown, the adapter 210 includes a first adapter 211 and a second adapter 212. The first adapter 211 is an adapter detachably connected to the operation cable 301. The second adapter 212 is an adapter detachably connected to the first attachment portion 1501 of the endoscope 100.

[0211] The operation receiving unit 220 receives an operation input from the operating device 300 via the operation cable 301. When the operating device 300 and the driving device 200 communicate with each other by wireless communication instead of wired communication, the operation receiving unit 220 includes a well-known wireless reception module.

[0212] The air supply and suction drive unit 230 is connected to the air supply and suction tube 172 inserted into the internal path 101 of the endoscope 100. The air supply and suction drive unit 230 includes a pump and the like, and supplies air to the air supply and suction tube 172. The air supply and suction drive unit 230 also sucks air from the air supply and suction tube 172.

[0213] The wire driving unit 250 is coupled to the first vertical bending wire detachable unit 151 , the first horizontal bending wire detachable unit 152 , the second vertical bending wire detachable unit 153 , and the second horizontal bending wire detachable unit 154 to drive the bending wire 160 .

[0214] like Figure 12As shown, the wire driving unit 250 includes a first vertical bending wire driving unit 251 , a first horizontal bending wire driving unit 252 , a second vertical bending wire driving unit 253 and a second horizontal bending wire driving unit 254 .

[0215] The first vertical bending wire driving unit 251 is coupled to the first vertical bending wire detachable unit 151 and drives the wires (the first upward bending wire 161 u and the first downward bending wire 161 d ) that bend the first bending portion 113 in the UD direction.

[0216] The first left-right bending wire driving unit 252 is connected to the first left-right bending wire detachable unit 152 and drives the wires (the first left bending wire 1611 and the first right bending wire 161r ) that bend the first bending portion 113 in the LR direction.

[0217] The second vertical bending wire driving unit 253 is coupled to the second vertical bending wire detachable unit 153 and drives the wires (the second upward bending wire 162u and the second downward bending wire 162d) that bend the second bending portion 114 in the UD direction.

[0218] The second left-right bending wire driving unit 254 is coupled to the second left-right bending wire detachable unit 154 and drives the wires (the second left bending wire 1621 and the second right bending wire 162r ) that bend the second bending portion 114 in the LR direction.

[0219] The first left-right bending wire drive unit 252 , the second up-down bending wire drive unit 253 , and the second left-right bending wire drive unit 254 have the same structure as the first up-down bending wire drive unit 251 , and therefore, illustration and description thereof are omitted.

[0220] like Figure 13 As shown, the first upper and lower bending wire driving unit 251 includes a supporting member 255 , a bending wire driving unit 256A, a coupling member 258 , and an attachment and detachment sensor 259 .

[0221] The bending wire driving unit 256A is coupled to the rotating drum 156 of the first upper and lower bending wire attaching and detaching unit 151 to drive the first upper bending wire 161u and the first lower bending wire 161d. The bending wire driving unit 256A includes a shaft 256a, a motor unit 256b, a coupled portion 256c, a torque sensor 256e, a fitting detection sensor 256f, and an elastic member 256s.

[0222] The shaft 256a is supported by the support member 255 so as to be rotatable about a shaft rotation axis 256r and to be movable forward and backward in the longitudinal direction A. When the first attachment and detachment portion 1501 of the endoscope 100 is attached to the drive device 200 , the shaft rotation axis 256r coincides with the drum rotation axis 156r.

[0223] The motor unit 256b includes a motor such as a DC motor, a motor driver for driving the motor, and a motor encoder. The motor rotates the shaft 256a about the shaft rotation axis 256r. The motor driver is controlled by a drive controller 260.

[0224] The connected portion 256c is a circular plate member that rotates around the shaft rotation axis 256r. The connected portion 256c is fixed to the front end of the shaft 256a and rotates integrally with the shaft 256a. Figure 13 As shown, the coupled portion 256c is exposed at the front end of the first vertical bending wire driving unit 251. Two engaging recesses 256d are formed on the front end surface of the coupled portion 256c. The two engaging recesses 256d are formed on both sides of the shaft rotation axis 256r.

[0225] like Figure 14 As shown, the engaging protrusion 156d engages with the engaging recess 256d, and the coupling portion 156c couples with the coupled portion 256c. As a result, the rotation of the shaft 256a driven by the motor portion 256b is transmitted to the rotating drum 156. Clockwise rotation of the shaft 256a, as viewed from the distal end toward the proximal end, pulls the first upper bending wire 161u and feeds the first lower bending wire 161d. Conversely, counterclockwise rotation of the first shaft 256a feeds the first upper bending wire 161u and pulls the first lower bending wire 161d.

[0226] The torque sensor 256e detects the rotational torque of the shaft 256a about the shaft rotation axis 256r. The detection result of the torque sensor 256e is obtained by the drive controller 260.

[0227] The fitting detection sensor 256f detects the fitting between the fitting protrusion 156d and the fitting recess 256d. Figure 14 As shown, coupled portion 256c is pressed into position by coupled portion 156c, thereby moving toward the base end (A2) along with shaft 256a. Fitting detection sensor 256f detects the engagement of fitting protrusion 256g provided on shaft 256a by detecting the proximity of fitting detection protrusion 256g, thereby detecting the engagement of fitting protrusion 156d with fitting recess 256d. The detection results of fitting detection sensor 256f are obtained by drive controller 260.

[0228] The elastic member 256s is, for example, a compression spring, the front end of which contacts the connected portion 256c, and the base end of which contacts the supporting member 255. The elastic member 256s urges the connected portion 256c toward the front end side (A1). Figure 13As shown, when the coupling portion 156c is removed, the coupled portion 256c moves toward the front end side (A1) together with the shaft 256a. As a result, the engagement detection sensor 256f cannot detect the engagement between the engagement protrusion 156d and the engagement recess 256d.

[0229] like Figure 14 As shown, the attachment / detachment sensor 259 detects the attachment / detachment of the first vertical bending wire attachment / detachment unit 151 relative to the first vertical bending wire driving unit 251 by detecting engagement / disengagement with the attachment / detachment detection protrusion 155a. The detection result of the attachment / detachment sensor 259 is acquired by the driving controller 260.

[0230] Figure 16 1 is a diagram showing the first vertical bending wire driving unit 251 to which the first vertical bending wire attaching and detaching unit 151 is attached. Figure 16 In the process, the attachment and detachment sensor 259 detects that the first vertical bending wire attachment and detachment unit 151 is attached to the first vertical bending wire driving unit 251 .

[0231] like Figure 16 As shown, when the coupling portion 156c is in contact with the coupled portion 256c but the engaging protrusion 156d is not engaged with the engaging recess 256d, the engaging detection sensor 256f cannot detect the engaging protrusion 156d and the engaging recess 256d. In this case, the drive controller 260 rotates the coupled portion 256c to a position where the engaging recess 256d and the engaging protrusion 156d can engage. As a result, the coupled portion 256c moves toward the front end (A1) via the elastic member 256s, thereby engaging the engaging protrusion 156d and the engaging recess 256d. The engaging detection sensor 256f detects the engaging protrusion 156d and the engaging recess 256d.

[0232] The drive controller 260 controls the entire drive device 200. The drive controller 260 receives the operation input received by the operation receiving unit 220. Based on the received operation input, the drive controller 260 controls the air supply and suction drive unit 230 and the wire drive unit 250. Furthermore, the drive controller 260 may also perform other processing such as image processing or image recognition processing.

[0233] Drive controller 260 is a computer programmable by a processor, memory, a storage unit capable of storing programs and data, and an input / output control unit. The functions of drive controller 260 are implemented by the processor executing the program. At least some of the functions of drive controller 260 may also be implemented by dedicated logic circuits.

[0234] The drive controller 260 is expected to have high computing performance so as to accurately control the plurality of motors that drive the plurality of bending wires 160 .

[0235] Furthermore, the drive controller 260 may include components other than a processor, memory, storage unit, and input / output control unit. For example, the drive controller 260 may also include an image processing unit that performs part or all of the image processing or image recognition processing. By also including an image processing unit, the drive controller 260 can execute specific image processing or image recognition processing at high speed. The image processing unit may also be installed in a separate hardware device connected via a communication line.

[0236] [Operating device 300]

[0237] Figure 17 It is a perspective view of the operating device 300 . Figure 18 This is a perspective view of the operating device 300 as viewed from the back surface 311 . Figure 19 It is a side view of the operating device 300.

[0238] The operating device 300 is a device for inputting an operation for driving the endoscope 100 . The input operation is transmitted to the driving device 200 via the operating cable 301 .

[0239] The operating device 300 includes an operating portion body 310 , a first angle knob 320 , a second angle knob 330 , a changeover switch 340 , an air supply button 350 , a suction button 351 , and various buttons 352 .

[0240] The operation unit body 310 is formed into a substantially cylindrical shape that can be held by the operator S with his left hand L. Figure 18 As shown, the operation unit body 310 has a back surface 311 formed thereon that can be positioned along the palm of the left hand L of the operator S. An operation cable 301 is connected to an end portion in the longitudinal direction of the operation unit body 310 .

[0241] The first and second angle knobs 320 and 330 are rotatably mounted on the operating unit body 310. The first and second angle knobs 320 and 330 are mounted on the front surface 312, opposite the back surface 311. The first and second angle knobs 320 and 330 rotate about the same rotation axis 300r. Rotational inputs to the first and second angle knobs 320 and 330 are transmitted to the drive device 200.

[0242] In the following description, the direction of the rotation axis 300r of the first angle knob 320 and the second angle knob 330 is defined as the "front-back direction", and the direction in which the first angle knob 320 and the second angle knob 330 are installed relative to the operating unit body 310 is defined as the "front FR". The opposite direction is defined as the "rear RR". In addition, the longitudinal direction of the operating unit body 310 is defined as the "upper-lower direction", and the direction in which the operating cable 301 is installed relative to the operating unit body 310 is defined as the "lower LWR". The opposite direction is defined as the "upper UPR". The right direction when facing the rear RR is defined as the "right RH". The opposite direction is defined as the "left LH". The direction toward the right RH or the left LH is defined as the "left-right direction".

[0243] In the present embodiment, the direction (front-back direction) of the rotation axis 300 r of the first angle knob 320 and the second angle knob 330 is substantially perpendicular to the back surface 311 of the operation portion body 310 .

[0244] The switch 340 is installed above the operating unit main body 310 UPR, as shown in FIG. Figure 18 It is operated by the thumb of the left hand L as shown. The switching switch 340 switches the bending mode of the bending portion 112 of the endoscope 100. The switching switch 340 has a rod switch 341 and a button switch 342. When the rod switch 341 of the switching switch 340 is tilted upward UPR, the bending mode becomes the "first bending portion control mode (front end side bending portion control mode) M1". When the rod switch 341 of the switching switch 340 is tilted downward LWR, the bending mode becomes the "second bending portion control mode (base end side bending portion control mode) M2". In addition, the bending mode can also be selected by the button switch 342. The selected bending mode is sent to the drive device 200.

[0245] The air supply button 350 is installed above the operating unit body 310 UPR, as shown in FIG. Figure 18 As shown, the air supply button 350 is operated by the index finger or middle finger of the left hand L. When the air supply button 350 is pressed, air is supplied from the opening 111a of the distal end portion 111 of the endoscope 100. The operation of the air supply button 350 is transmitted to the drive device 200.

[0246] The suction button 351 is installed on the upper side UPR of the operation unit main body 310. Figure 18 As shown, it is operated by the index finger or middle finger of the left hand L. When the suction button 351 is pressed, suction is performed from the opening 111a of the distal end portion 111 of the endoscope 100. The operation of the suction button 351 is transmitted to the drive device 200.

[0247] The drive controller 260 of the drive device 200 receives an operation input from the operating device 300 and controls the air supply and suction drive unit 230 and the wire drive unit 250 .

[0248] When the bending mode is the first bending portion control mode M1, the drive controller 260 controls the first upper and lower bending wire drive unit 251 based on the rotation of the first angle knob 320 to drive the wires (the first upper bending wire 161u and the first lower bending wire 161d) that bend the first bending portion 113 in the UD direction. Furthermore, the drive controller 260 controls the first left and right bending wire drive unit 252 based on the rotation of the second angle knob 330 to drive the wires (the first left bending wire 161l and the first right bending wire 161r) that bend the first bending portion 113 in the LR direction.

[0249] When the bending mode is the second bending portion control mode M2, the drive controller 260 controls the second upper and lower bending wire drive unit 253 based on the rotation of the first angle knob 320 to drive the wires (the second upper bending wire 162u and the second lower bending wire 162d) that bend the second bending portion 114 in the UD direction. Furthermore, the drive controller 260 controls the second left and right bending wire drive unit 254 based on the rotation of the second angle knob 330 to drive the wires (the second left bending wire 162l and the second right bending wire 162r) that bend the second bending portion 114 in the LR direction.

[0250] When the lever switch 341 is tilted upward (UPR), the bending mode becomes "first bending section control mode M1," in which the distal first bending section 113 is bent. On the other hand, when the lever switch 341 is tilted downward (LWR), the bending mode becomes "second bending section control mode M2," in which the proximal second bending section 114 is bent. This allows the surgeon S to intuitively switch between bending modes.

[0251] When the upper UPR of the operating device 300 is aligned with the front end side (A1) of the longitudinal direction A of the endoscope 100, the rotation direction of the first angle knob 320 and the second angle knob 330 is consistent with the bending direction of the bending portion 112 at the front end of the endoscope 100. In addition, the operation method of bending the first bending portion 113 of the front end side (A1) in response to the tilting of the rod switch 341 toward the upper UPR is consistent, which promotes intuitive operation. Similarly, the operation method of bending the second bending portion 114 of the base end side (A2) in response to the tilting of the rod switch 341 toward the lower LWR direction also becomes an intuitive correspondence for the operator, and has good operability.

[0252] The operating device 300 does not include a driving mechanism for driving the bending portion 112 of the endoscope 100, and is therefore compact and lightweight. In addition, the first angle knob 320, the second angle knob 330, the air supply button 350, the suction button 351, and the various buttons 352 are arranged in positions where the surgeon S can fully operate them using only his left hand L. Figure 2 As shown, the surgeon S can easily hold the operating device 300 with only his left hand L to operate it.

[0253] Figure 20 It is a perspective view of the operating device 300 to which the second forceps jaw fixing tool 360 is attached.

[0254] The second jaw fixing tool 360 can be attached to the operating device 300. The second jaw fixing tool 360 is attached to the operating device 300 by snap-fitting, adhesive sheets, magnets, etc. The second jaw fixing tool 360 has a second jaw 361 formed in a substantially cylindrical shape.

[0255] The second forceps opening 361 has a first opening 362 and a second opening 363 that communicate with the internal space. The extension channel tube 130 is connected to the second opening 363. The second opening 363 can be connected to the forceps opening 126 of the connecting portion 120 via the extension channel tube 130. The surgeon S can insert the treatment instrument 400 through the first opening 362 of the second forceps opening 361 and pass the treatment instrument 400 through the channel tube 171 via the extension channel tube 130 and the forceps opening 126.

[0256] Figure 20 The second jaw fixing tool 360 is mounted at the same position as the jaws of the conventional flexible endoscope operation unit. Therefore, the surgeon S can operate the operation device 300 and the treatment instrument 400 with the same operating feel as the conventional flexible endoscope operation unit.

[0257] The second forceps jaw fixing tool 360 may be installed at any location on the operating device 300. The second forceps jaw fixing tool 360 is installed at a location where the surgical instrument 400 can be easily operated by the surgeon S. Two or more second forceps jaw fixing tools 360 may be installed on the operating device 300.

[0258] [Image control device 500]

[0259] Figure 21 This is a functional block diagram of the image control device 500 .

[0260] The image control device 500 controls the electric endoscope system 1000. The image control device 500 includes a third adapter 510, an image processing unit 520, a light source unit 530, and a main controller 560.

[0261] The third adapter 510 is an adapter that is detachably connected to the second attachment / detachment portion 1502 of the endoscope 100 .

[0262] The imaging processing unit 520 converts an imaging signal acquired from the imaging unit 111 c of the distal end portion 111 via the imaging cable 173 into a captured image.

[0263] The light source unit 530 generates illumination light to be irradiated toward an imaging subject. The illumination light generated by the light source unit 530 is guided to the illumination unit 111 b of the distal end portion 111 via the light guide 174 .

[0264] Figure 22 is a functional block diagram of the main controller 560.

[0265] The main controller 560 is a computer that is equipped with a processor 561 and a memory 562. The functions of the main controller 560 are realized by the execution of the program by the processor 561. At least part of the functions of the main controller 560 may be realized by a dedicated logic circuit.

[0266] The main controller 560 includes a processor 561 , a memory 562 capable of reading programs, a storage unit 563 , and an input / output control unit 564 .

[0267] The storage unit 563 is a nonvolatile recording medium that stores the above-mentioned programs and necessary data. The storage unit 563 is composed of, for example, a ROM or a hard disk. The program recorded in the storage unit 563 is read into the memory 562 and executed by the processor 561.

[0268] The input / output control unit 564 is connected to the image processing unit 520, the light source unit 530, the drive device 200, the display device 900, an input device (not shown), and a network device (not shown). Based on the control of the processor 561, the input / output control unit 564 transmits and receives data and control signals to and from the connected devices.

[0269] The main controller 560 can perform image processing on the captured images acquired by the image processing unit 520 . The main controller 560 can generate GUI images and CG images for the purpose of providing information to the surgeon S. The main controller 560 can display the captured images, GUI images, and CG images on the display device 900 .

[0270] The main controller 560 is connected to the hospital network and can obtain information such as electronic medical records from the server. In addition, the main controller 560 can also be connected to the Internet to perform maintenance of the endoscope 100 via the Internet.

[0271] The main controller 560 is not limited to being a single hardware device. For example, the main controller 560 may be configured by separating some of the hardware devices as separate components and then connecting the separate hardware components via a communication line. For example, the main controller 560 may also be configured by connecting a separate storage unit 563 to a cloud system via a communication line.

[0272] The main controller 560 also has Figure 22 The main controller 560 includes a configuration other than the processor 561, memory 562, storage unit 563, and input / output control unit 564 shown. For example, the main controller 560 further includes an image processing unit that performs part or all of the image processing or image recognition processing performed by the processor 561. By also including the image processing unit, the main controller 560 can execute specific image processing or image recognition processing at high speed. The image processing unit can also be installed in a separate hardware device connected via a communication line.

[0273] The electric endoscope system 1000 of this embodiment can more effectively perform observation or treatment using the endoscope 100. Since the endoscope 100 is separated from the operating device 300, the operator S can operate the endoscope 100 and the operating device 300 independently without affecting each other.

[0274] When the surgeon S rotates the internal flexible portion 119 of the insertion section 110 about the rotation axis extending along the longitudinal direction A, only the internal flexible portion 119 can be rotated. Therefore, the surgeon S can easily perform a rotational operation on the internal flexible portion 119. On the other hand, unless the surgeon S rotates the internal flexible portion 119 of the insertion section 110, the internal flexible portion 119 will not rotate relative to the external flexible portion 140. Therefore, even if the surgeon S removes his right hand R from the internal flexible portion 119 to operate the treatment instrument 400, for example, the internal flexible portion 119 will not rotate relative to the external flexible portion 140.

[0275] The driving mechanism for driving the bending portion 112 is provided in the driving device 200, not in the operating device 300. Therefore, the operating device 300 can be easily miniaturized, and the operator S can easily operate the operating device 300 with one hand.

[0276] The surgeon S switches the bending mode by toggling the switch 340. This allows the surgeon S to operate the bending portion 112, which has a two-stage bending function (multi-stage bending function) in which the first bending portion 113 and the second bending portion 114 are bent using only the first angle knob 320 and the second angle knob 330. The operating device 300 does not need to have separate angle knobs for operating the first bending portion 113 and the second bending portion 114. Therefore, the operating device 300 can be easily miniaturized, making it easy for the surgeon S to operate the operating device 300 with one hand.

[0277] The first embodiment of the present invention has been described in detail with reference to the accompanying drawings, but the specific structure is not limited to this embodiment and includes design changes within the scope of the present invention. In addition, the structural elements shown in the above-mentioned embodiment and modification examples can be appropriately combined and configured.

[0278] (Variation 1-1)

[0279] In the above embodiment, the surgeon S operates the endoscope 100 with his right hand R while operating the operating device 300 with his left hand L. However, the use of the electric endoscope system 1000 is not limited to this. The surgeon S may also operate the endoscope 100 with his left hand L while operating the operating device 300 with his right hand R. In this case, the operating device 300 is optimized for easy operation with the right hand R.

[0280] (Variation 1-2)

[0281] In the above embodiment, the bending portion 112 has a bending function (multi-stage bending function) in which the first bending portion 113 and the second bending portion 114 bend in two stages. However, the bending portion 112 is not limited to this. The bending portion 112 may have only the second bending portion 114 without the first bending portion 113. The bending portion 112 may also have a third bending portion, allowing it to bend in three stages.

[0282] (Variation 1-3)

[0283] In the above embodiment, the operation cable 301 is attached to the longitudinal end of the operation portion main body 310. However, the connection position of the operation cable 301 in the operation portion main body 310 is not limited thereto. Figure 23 300A is a perspective view of an operating device 300A as a modified example of the operating device 300. The operating device 300A includes an operating portion body 310A, a first angle knob 320, a second angle knob 330, a selector switch 340, an air supply button 350, a suction button 351, and various buttons 352.

[0284] The operation unit body 310A is different from the operation unit body 310 of the operation device 300 of the above embodiment in the position where the operation cable 301 is connected. The operation unit body 310A includes an operation cable connection portion 313 to which the operation cable 301 is connected.

[0285] The operation cable connection portion 313 is provided above the operation unit body 310A UPR and near the selector switch 340. The operation cable connection portion 313 extends from the back surface 311 of the operation unit body 310A to the left LH. Alternatively, the operation cable connection portion 313 may extend from a side surface of the operation unit body 310A to the left LH.

[0286] The operating cable connection portion 313 is provided at a position equivalent to the location where the universal cable is connected in the operating unit of a conventional flexible endoscope. Therefore, the operator S can stably hold the operating device 300A by pinching the operating cable connection portion 313 between the thumb and index finger of his left hand L, as in the case of conventional flexible endoscope operating units.

[0287] The operating device 300A can also communicate with the drive device 200 via wireless communication, without the operating cable 301 connected to the operating device 300A. Wireless communication allows the left hand L to more freely hold the operating device 300. Furthermore, even when wireless communication is used, the operating unit body 310A can be provided with an operating cable connection portion 313, to which the operating cable 301 is not connected, to facilitate holding the operating device 300 between the thumb and index finger of the left hand L. By pinching the operating cable connection portion 313 between the thumb and index finger of the left hand L, the surgeon S can stably hold the operating device 300A.

[0288] (Variation 1-4)

[0289] In the above embodiment, the second forceps jaw fixing tool 360 is attached to the same position as the forceps jaw in the operating portion of a conventional flexible endoscope. However, the attachment position of the second forceps jaw fixing tool 360 is not limited thereto. Figure 24 It is a perspective view of the operating device 300 with the second forceps jaw fixing tool 360 installed at a different position. Figure 24 The second forceps jaw fixing tool 360 is shown mounted on the back surface 311 of the operating portion body 310 . Figure 24 The first opening 362 of the illustrated second forceps jaw fixing tool 360 is arranged near the suction button 351 of the operation portion main body 310 .

[0290] Figure 25 It shows Figure 24 FIG. 1 is a diagram showing an example of use of the operating device 300 shown.

[0291] The surgeon S inserts the treatment instrument 400 through the first opening 362 and passes through the channel tube 171 via the extension channel tube 130 and the forceps opening 126. The surgeon S can hold the operating device 300 with his left hand L and grasp the treatment instrument 400 inserted through the first opening 362 with the index and middle fingers of his left hand L. The surgeon S can rotate the first angle knob 320 and the second angle knob 330 with the thumb of his left hand L while moving the treatment instrument 400 forward and backward with the index and middle fingers of his left hand L. The surgeon S can also grasp the treatment instrument 400 with fingers other than the index and middle fingers of his left hand L.

[0292] By attaching the second forceps jaw fixing tool 360 to the operating device 300 so that the treatment instrument 400 can be operated with the left hand L, the surgeon S can operate the treatment instrument 400 with his left hand L. Therefore, the surgeon S does not need to remove his right hand R from the endoscope 100 to operate the treatment instrument 400. The surgeon S can maintain support for the insertion portion 110 of the endoscope 100 with his right hand R while operating the operating device 300 or the treatment instrument 400. The second forceps jaw fixing tool 360 can be attached to the optimal position for the surgeon S, matching the size of the surgeon's left hand L.

[0293] (Variation 1-5)

[0294] In the above embodiment, the electric endoscope system 1000 may further include a well-known endoscope attachment such as "smart shooter (registered trademark)". By using the endoscope attachment, the surgeon S can advance and retract the treatment instrument 400 while holding the insertion portion 110 with his right hand R.

[0295] (Second embodiment)

[0296] Reference Figures 26 to 30 Next, an electric endoscope system 1000B according to a second embodiment of the present invention will be described. In the following description, the same reference numerals are assigned to the same components as those already described, and duplicate descriptions will be omitted. Figure 26 It is an overall view of the electric endoscope system 1000B according to this embodiment.

[0297] [Electric Endoscope System 1000B]

[0298] like Figure 26As shown, an electric endoscope system 1000B is a medical system for observing and treating the body of a patient P lying on an operating table T. The electric endoscope system 1000B includes an endoscope 100, a drive device 200B, an operating device 300B, a treatment instrument 400, an image control device 500, and a display device 900. The drive device 200B and the image control device 500 constitute a control device 600B that controls the electric endoscope system 1000B.

[0299] [Drive device 200B]

[0300] Figure 27 This is a functional block diagram of the driving device 200B.

[0301] The driving device 200B includes an adapter 210 , an operation receiving unit 220 , an air supply and suction driving unit 230 , a wire driving unit 250 , and a driving controller 260B.

[0302] Figure 28 is the migration diagram of the bending mode.

[0303] The drive controller 260B has the same structure as the drive controller 260 of the first embodiment, except that the bending mode of the controlled bending portion 112 is different. In addition to the "first bending portion control mode (distal bending portion control mode) M1" and the "second bending portion control mode (proximal bending portion control mode) M2," the bending mode of the bending portion 112 controlled by the drive controller 260B also includes a "coordinated control mode M3" for controlling the first bending portion 113 and the second bending portion 114 in a coordinated manner. The bending modes in the coordinated control mode M3 are further classified into a "simulated single bending control mode M4 (first mode)" in which the bending portion 112 bends as a single bending portion; a "coordinated bending control mode M5 (second mode)" in which the first bending portion 113 and the second bending portion 114 bend in a coordinated manner; and a "simulated single bending transition mode M6 (third mode)."

[0304] When the bending mode is the simulated single bending control mode M4, the drive controller 260B controls the first bending portion 113 and the second bending portion 114 simultaneously. The drive controller 260B drives the first bending wire 161 and the second bending wire 162 so that the first bending portion 113 and the second bending portion 114 bend in the same direction relative to the longitudinal direction A. The drive controller 260B simulates the bending portion 112, which has the first bending portion 113 and the second bending portion 114 and bends in two stages, as a single bending portion. The bending portion 112 is controlled to have the curved shape (hereinafter referred to as the "single bending shape") of the bending portion in a conventional flexible endoscope that does not have a bending function that bends the bending portion in multiple stages (multi-stage bending function).

[0305] When the bending mode is the coordinated bending control mode M5, the drive controller 260B simultaneously controls the first bending portion 113 and the second bending portion 114. The drive controller 260B drives the first bending wire 161 and the second bending wire 162 to bend the first bending portion 113 and the second bending portion 114 in opposite directions relative to the longitudinal direction A.

[0306] Specifically, when the bending mode is the simulated single bending control mode M4 or the coordinated bending control mode M5, the drive controller 260B controls the first upper and lower bending wire drive units 251 and the second upper and lower bending wire drive units 253 based on the rotation of the first angle knob 320, thereby driving the wires (the first upper bending wire 161u and the first lower bending wire 161d) that bend the first bending portion 113 in the UD direction and the wires (the second upper bending wire 162u and the second lower bending wire 162d) that bend the second bending portion 114 in the UD direction. Furthermore, the drive controller 260B controls the first left and right bending wire drive units 252 and the second left and right bending wire drive units 254 based on the rotation of the second angle knob 330, thereby driving the wires (the first left bending wire 161l and the first right bending wire 161r) that bend the first bending portion 113 in the LR direction and the wires (the second left bending wire 162l and the second right bending wire 162r) that bend the second bending portion 114 in the LR direction.

[0307] When the bending mode is the simulated single bending transition mode M6, the driving controller 260B controls at least one of the first bending portion 113 and the second bending portion 114. The driving controller 260B drives at least one of the first bending wire 161 and the second bending wire 162 to transform the bending portion 112 into a single bending shape.

[0308] When the bending mode is the simulated single-bend transition mode M6, the drive controller 260B can also control the driving of the second curved portion 114 based on the curvature of the first curved portion 113, thereby ensuring that the curvatures of the first and second curved portions 113, 114 are substantially the same. Conversely, the drive controller 260B can also control the driving of the first curved portion 113 based on the curvature of the second curved portion 114, thereby ensuring that the curvatures of the first and second curved portions 113, 114 are substantially the same. By controlling the driving of the first curved portion 113 based on the curvature of the second curved portion 114, the amount of front-end movement can be reduced and the curvatures can be made consistent as safely as possible. In other words, the curved shapes of the first and second curved portions 113, 114 can be made consistent. Whether to use the curvature of the first or second curved portion 114 as a reference can also be determined based on the previous bending mode. For example, when the previous bending mode simulating the single bending transition mode M6 is the first bending portion control mode (front end bending portion control mode) M1 , the second bending portion 114 is driven and controlled based on the curvature of the first bending portion 113 .

[0309] When the bending mode transitions from another bending mode to the pseudo-single bending control mode M4, the curved portion 112 may not have a single bend but instead adopts a multi-step bend. A multi-step bend may be, for example, a bend in which the first and second bends 113 and 114 bend in different directions relative to the longitudinal direction A, or a bend in which the first and second bends 113 and 114 bend in the same direction but have different curvatures. In this case, the drive controller 260B transitions the bending mode to the pseudo-single bending transition mode M6, causing the curved portion 112 to transition to a single bend.

[0310] When the bending mode transitions from another bending mode to the pseudo single bending control mode M4 , if the bending portion 112 is already in a single curved shape, the drive controller 260B transitions the bending mode to the pseudo single bending control mode M4 without passing through the pseudo single bending transition mode M6 .

[0311] When the bending mode is the simulated single bending transition mode M6, the driving controller 260B disables the rotation operation of the first and second angle knobs 320 and 330. The driving controller 260B transitions the bending portion 112 into the single bending shape regardless of the rotation operation of the first and second angle knobs 320 and 330.

[0312] In addition, when the bending mode is the simulated single bending transition mode M6, the drive controller 260B may not invalidate the rotation operation of the first angle knob 320 or the second angle knob 330, and only when the rotation operation is performed, at least one of the first bending part 113 and the second bending part 114 is moved and transformed into a single bending shape.

[0313] After converting the shape of the bending portion 112 into the single-bend shape, the driving controller 260B switches the bending mode from the pseudo single-bend conversion mode M6 to the pseudo single-bend control mode M4 . The driving controller 260B validates the rotation operations of the first angle knob 320 and the second angle knob 330 .

[0314] [Operation device 300B]

[0315] The operating device 300B includes an operating unit body 310, a first angle knob 320, a second angle knob 330, a switch 340B, an air supply button 350, a suction button 351, and various buttons 352. Figure 26 The illustrated operating device 300B is equipped with a second forceps jaw fixing device 360 ​​.

[0316] Figure 29 340B is a diagram showing a changeover switch 340B.

[0317] The selector switch 340B is mounted on the upper portion UPR of the operation unit body 310 similarly to the selector switch 340 of the first embodiment and is operated by the thumb of the left hand L. The selector switch 340B switches the bending mode of the bending portion 112 of the endoscope 100. The selector switch 340B includes a lever switch 341B and a push button switch 342B.

[0318] like Figure 29 As shown, the lever switch 341B can be moved to three positions: an upper position (first position) L1, a lower position (second position) L2, and a center position (third position) L3. The push button switch 342B can be moved to two positions: a standard position B1 and a pressed position B2, which is pressed from the standard position B1. The push button switch 342B has a locking mechanism that holds the push button switch 342B in the pressed position B2 until it is pressed again.

[0319] When the lever switch 341B is tilted upward (UPR) and moved to the upper position (L1), the bending mode becomes the first bending section control mode (M1). When the lever switch 341B is tilted downward (LWR) and moved to the lower position (L2), the bending mode becomes the second bending section control mode (M2). When the lever switch 341B is positioned in the center position (L3), the bending mode becomes the coordinated control mode (M3). When the push button switch 342B is positioned in the standard position (B1) in the coordinated control mode (M3), the bending mode becomes the simulated single bending control mode (M4). When the push button switch 342B is positioned in the pressed position (B2) in the coordinated control mode (M3), the bending mode becomes the coordinated bending control mode (M5). The selected bending mode is transmitted to the drive controller 260B of the drive device 200B.

[0320] The center position (third position) L3 is located on the path of the lever switch 341B moving from either the upper position (first position) L1 or the lower position (second position) L2. Therefore, when the surgeon S switches the bending mode from either the first bending section control mode M1 or the second bending section control mode M2 ​​to the other, the bending mode must pass through the coordinated control mode M3.

[0321] Moving the lever switch 341 to the upper position L1 results in the first bending section control mode M1, in which the first bending section 113 on the distal end side (A1) is bent. Moving the lever switch 341 to the lower position L3 results in the second bending section control mode M2, in which the second bending section 114 on the proximal end side (A2) is bent. Furthermore, moving the lever switch 341 to the center position L3 results in the coordinated control mode M3. In the coordinated control mode M3, in which the first and second bending sections 113 and 114 are bent, the center position L3 is set between the upper position L1 and the lower position L2, making it easy for the operator to intuitively operate the lever switch 341.

[0322] Next, a method of using the electric endoscope system 1000B of this embodiment will be described. Specifically, a surgical procedure for observing and treating an affected area formed on the tube wall in the large intestine using the electric endoscope system 1000B will be described.

[0323] The surgeon S inserts the insertion portion 110 of the endoscope 100 from the front end through the anus of the patient P into the large intestine. Figure 2 As shown, while observing the camera image displayed on the display device 900, the surgeon S uses his right hand R to operate the soft part 119 inside the body, thereby moving the insertion portion 110 and bringing the distal end portion 111 closer to the affected area. Furthermore, the surgeon S uses his left hand L to operate the first angle knob 320 and the second angle knob 330 of the operating device 300B to bend the bending portion 112 as needed.

[0324] For example, when inserting the insertion section 110 into the large intestine, the surgeon S sets the bending mode of the bending section 112 to the simulated single bending control mode M4. The drive controller 260B bends the bending section 112 as a single bending section. By moving the bending section 112 as in conventional endoscopes, the surgeon S can hook the large intestine and shorten it. Therefore, the surgeon S can insert the insertion section 110 into the large intestine by operating the operating device 300B in the same manner as with conventional flexible endoscopes that do not have a bending function that allows the bending section to bend in multiple stages (multi-stage bending function).

[0325] In an existing single-bend endoscope, after the affected part enters the field of view, the degree of freedom of the bending part is used to approach the affected part. Thereafter, the bending part is operated to further perform therapeutic actions (treatment). However, the degree of freedom for approaching the affected part and the degree of freedom for performing treatment after approaching are operated by the same bending part, so complex coordination actions are required during treatment. In the electric endoscope system 1000B of this embodiment, the surgeon S sets the bending mode of the bending part 112 to the second bending part control mode M2 ​​when, for example, he wants to bring the camera part 111c close to the affected part. The drive controller 260B bends only the second bending part 114. Since the bending part 112 is bent only on the base end side, it is possible to approach the affected part without narrowing the movable range of the first bending part 113 on the front end side. Thereafter, when switching to the first bending control mode M1, the first bending part 113 can be operated while maintaining the shape of the second bending part 114. Therefore, the surgeon S can perform treatment while being close to the affected part, and the operation can be facilitated.

[0326] Figure 30 1 is a diagram showing the bending portion 112 controlled in the coordinated bending control mode M5 .

[0327] For example, when the surgeon S wants to move the field of view in the horizontal direction, he sets the bending mode of the bending portion 112 to the coordinated bending control mode M5. Figure 30 As shown, the drive controller 260B bends the first bending portion 113 and the second bending portion 114 in opposite directions relative to the longitudinal direction A. Specifically, when the second bending portion 114 is bent at an angle α relative to the longitudinal direction A, the first bending portion 113 is bent at an angle -α relative to the longitudinal direction A. As a result, the field of view of the imaging unit 111c is maintained substantially constant. While maintaining the field of view of the imaging unit 111c substantially constant, the surgeon S can easily change the position of the distal end portion 111.

[0328] For example, when using the treatment instrument 400 to incise the periphery of an affected area, the surgeon S sets the bending mode of the curved portion 112 to the first bending portion control mode M1. The drive controller 260B bends only the first bending portion 113. Since the curved portion 112 bends only at the distal end, the rotation radius is small. Therefore, the surgeon S can easily move the treatment portion 410 of the treatment instrument 400, which protrudes from the opening 111a of the distal end 111, to a desired position with high precision as the curved portion 112 bends, making it easier for the surgeon to treat the affected area.

[0329] For example, after completing a surgical procedure and removing the insertion portion 110 from the large intestine, the surgeon S sets the bending mode of the bending portion 112 to the pseudo single bending control mode M4. If the bending portion 112 does not have a single bend but rather a multi-step bend, the drive controller 260B transitions the bending mode to the pseudo single bending control mode M4 via the pseudo single bending transition mode M6. As a result, after setting the bending mode to the pseudo single bending control mode M4, the surgeon S can smoothly perform the procedure by setting the bending portion 112 to a single bend.

[0330] According to the electric endoscope system 1000B of this embodiment, observation or treatment using the endoscope 100 can be performed more efficiently. Because the drive controller 260B can drive the bending portion 112 in multiple bending modes, the surgeon S can appropriately control the bending portion 112 in various scenarios during a surgical procedure using the endoscope 100. This reduces the burden on the surgeon S during the surgical procedure and shortens the surgical procedure time.

[0331] By switching the bending mode using the switch 340B, the surgeon S can operate the bending portion 112, which has a bending function (multi-stage bending function) in which the first bending portion 113 and the second bending portion 114 are bent in two stages, using only the first angle knob 320 and the second angle knob 330. The operating device 300B does not need to have separate angle knobs for operating the first bending portion 113 and the second bending portion 114. Therefore, the operating device 300B can be easily miniaturized, making it easy for the surgeon S to operate the operating device 300B with one hand.

[0332] The second embodiment of the present invention has been described in detail with reference to the accompanying drawings, but the specific structure is not limited to this embodiment and includes design changes within the scope of the present invention. In addition, the structural elements shown in the above-mentioned embodiment and modification examples can be appropriately combined and configured.

[0333] (Variation 2-1)

[0334] In the above embodiment, when the bending mode is the coordinated bending control mode M5, the drive controller 260B causes the first curved portion 113 and the second curved portion 114 to bend in opposite directions relative to the longitudinal direction A. However, the driving method of the curved portion 112 controlled in the coordinated bending control mode M5 is not limited to this. For example, the drive controller 260B may cause the first curved portion 113 and the second curved portion 114 to bend while maintaining the position of the distal end of the curved portion 112. The angles at which the first curved portion 113 and the second curved portion 114 are bent relative to the longitudinal direction A are calculated by the drive controller 260B based on the position of the distal end of the curved portion 112. For example, the drive controller 260B calculates the angles at which the first curved portion 113 and the second curved portion 114 are bent using inverse kinematics, while causing the first curved portion 113 and the second curved portion 114 to bend while maintaining the position of the distal end of the curved portion 112 as much as possible.

[0335] (Third embodiment)

[0336] Reference Figures 31 to 37 A motor-driven endoscope system 1000C according to a third embodiment of the present invention will be described. In the following description, the same reference numerals are assigned to the same components as those already described, and duplicate descriptions will be omitted. Figure 31 It is an overall view of the electric endoscope system 1000C according to this embodiment.

[0337] [Electric Endoscope System 1000C]

[0338] like Figure 31 As shown, an electric endoscope system 1000C is a medical system for observing and treating the body of a patient P lying on an operating table T. The electric endoscope system 1000C includes an endoscope 100C, a drive device 200C, an operating device 300, a treatment instrument 400, an image control device 500, and a display device 900. The drive device 200C and the image control device 500 constitute a control device 600C that controls the electric endoscope system 1000C.

[0339] [Endoscope 100C]

[0340] The endoscope 100C includes an insertion portion 110, a connecting portion 120, an external flexible portion 140, a detachable portion 150C, a bending wire 160, and an internal component 170. The insertion portion 110, the connecting portion 120, the external flexible portion 140, and the detachable portion 150C are connected in order from the distal end side.

[0341] [Attachment and removal section 150C]

[0342] like Figure 31As shown, the attachment unit 150C includes a first attachment unit 1503 attached to the driving device 200C and a second attachment unit 1502 attached to the image control device 500. Alternatively, the first attachment unit 1503 and the second attachment unit 1502 may be an integrated attachment unit.

[0343] The internal path 101 formed inside the external flexible portion 140 branches toward the first detachable portion 1503 and the second detachable portion 1502. The bending wire 160 and the air supply and suction tube 172 are inserted through the first detachable portion 1503. The imaging cable 173 and the light guide 174 are inserted through the second detachable portion 1502.

[0344] Figure 32 This is a diagram showing the first attachment / detachment portion 1503 before being attached to the drive device 200C.

[0345] The first attaching and detaching portion 1503 includes a first vertical bending wire attaching and detaching portion 151C, a first horizontal bending wire attaching and detaching portion 152C, a second vertical bending wire attaching and detaching portion 153C, and a second horizontal bending wire attaching and detaching portion 154C.

[0346] The first upper and lower bending wire detachable portion 151C is a mechanism that detachably connects the wires (the first upper bending wire 161u and the first lower bending wire 161d) that bend the first bending portion 113 in the UD direction to the driving device 200C.

[0347] The first left-right bending wire detachable portion 152C is a mechanism that detachably connects the wires (the first left bending wire 1611 and the first right bending wire 161r) that bend the first bending portion 113 in the LR direction to the drive device 200C.

[0348] The second upper and lower bending wire detachable portion 153C is a mechanism that detachably connects the wires (the second upper bending wire 162u and the second lower bending wire 162d) for bending the second bending portion 114 in the UD direction to the driving device 200C.

[0349] The second left-right bending wire detachable portion 154C is a mechanism that detachably connects the wires (the second left bending wire 1621 and the second right bending wire 162r) that bend the second bending portion 114 in the LR direction to the drive device 200C.

[0350] The first left-right bending wire detachable portion 152C, the second up-down bending wire detachable portion 153C, and the second left-right bending wire detachable portion 154C have the same structure as the first up-down bending wire detachable portion 151C, and therefore, illustration and description thereof are omitted.

[0351] Figure 33 This is a diagram showing the first vertical bending wire attaching and detaching portion 151C before being attached to the driving device 200C. Figure 34The diagram shows a first vertical bending wire detachable portion 151C attached to a driving device 200C. The first vertical bending wire detachable portion 151C includes a support member 155 , a first rotating drum 156 , a second rotating drum 157 , a connecting member 158 , and a tension sensor 159 .

[0352] The support member 155 supports the first rotating roller 156, the second rotating roller 157, and the connecting member 158. The support member 155 includes an attachment and detachment detection protrusion 155a exposed on the base end side of the first vertical bending wire attachment and detachment portion 151C, and a plurality of turning rollers 155p.

[0353] The turning wheel 155p changes the conveying direction of the first upper curved wire 161u passing through the flexible portion 140 inserted outside the body, and guides the first upper curved wire 161u to the first rotating drum 156. Furthermore, the turning wheel 155p changes the conveying direction of the first lower curved wire 161d passing through the flexible portion 140 inserted outside the body, and guides the first lower curved wire 161d to the second rotating drum 157.

[0354] The first rotating drum 156 is supported by the supporting member 155 so as to be rotatable around a first drum rotating shaft 156 r extending in the longitudinal direction A. The first rotating drum 156 includes a first winding wheel 156 a , a first gear 156 b , and a first coupling portion 156 c .

[0355] The first winding wheel 156a rotates about the first roller rotation axis 156r, pulling or feeding the first upper bending wire (first bending wire) 161u. When viewed from the distal end toward the proximal end, the first winding wheel 156a rotates clockwise, winding the first upper bending wire 161u around the first winding wheel 156a and feeding it. Conversely, when the first winding wheel 156a rotates counterclockwise, feeding the first upper bending wire 161u from the first winding wheel 156a. This structure ensures that even if the first upper bending wire 161u moves forward or backward significantly, the pulled portion is compactly stored without taking up space.

[0356] The first gear 156b is a spur gear that rotates around the first roller rotation shaft 156r. The first gear 156b is fixed to the first winding wheel 156a and rotates integrally with the first winding wheel 156a.

[0357] The first coupling portion 156c is a circular plate member that rotates around the first roller rotation axis 156r. The first coupling portion 156c is fixed to the base end of the first winding wheel 156a and rotates integrally with the first winding wheel 156a. The first coupling portion 156c is exposed at the base end of the first upper and lower bending wire attachment and detachment portion 151C. Two first interlocking protrusions 156d are formed on the surface of the base end of the first coupling portion 156c. The two first interlocking protrusions 156d are formed on both sides of the first roller rotation axis 156r.

[0358] The second rotating drum 157 is supported by the supporting member 155 so as to be rotatable around a second drum rotating shaft 157r extending in the longitudinal direction A. The second rotating drum 157 includes a second winding wheel 157a, a second gear 157b, and a second coupling portion 157c.

[0359] The second winding wheel 157a rotates about the second roller rotation axis 157r, pulling or feeding the first lower bending wire (second bending wire) 161d. When the second winding wheel 157a rotates counterclockwise (as viewed from the distal end toward the proximal end), the first lower bending wire 161d is wound around the second winding wheel 157a and pulled. Conversely, when the second winding wheel 157a rotates clockwise, the first lower bending wire 161d is fed from the second winding wheel 157a.

[0360] The second gear 157b is a spur gear that rotates around the second roller rotation shaft 157r. The second gear 157b is fixed to the second winding wheel 157a and rotates integrally with the second winding wheel 157a.

[0361] The second coupling portion 157c is a circular plate member that rotates around the second roller rotation axis 157r. The second coupling portion 157c is fixed to the base end of the second winding wheel 157a and rotates integrally with the second winding wheel 157a. The second coupling portion 157c is exposed at the base end side of the first upper and lower bending wire attachment and detachment portion 151C. Two second interlocking protrusions 157d are formed on the surface of the base end side of the second coupling portion 157c. The two second interlocking protrusions 157d are formed on both sides of the second roller rotation axis 157r.

[0362] The connecting member (switching mechanism) 158 is a member that connects the first rotating drum 156 and the second rotating drum 157. The connecting member 158 includes a cylindrical member 158a, an interlocking gear 158b, and an elastic member 158c.

[0363] The cylindrical member 158a is supported by the support member 155 so as to be rotatable about a third rotation axis 158r extending in the longitudinal direction A and to be able to advance and retreat in the longitudinal direction A. The third rotation axis 158r is parallel to the first roller rotation axis 156r and the second roller rotation axis 157r. The base end of the cylindrical member 158a is exposed on the base end side of the first vertical bending wire attachment and detachment portion 151C.

[0364] The interlocking gear 158b is a spur gear that rotates around the third rotation shaft 158r. The interlocking gear 158b is fixed to the cylindrical member 158a and rotates integrally with the cylindrical member 158a.

[0365] The elastic member 158c is, for example, a spring, which applies force to the cylindrical member 158a and the interlocking gear 158b toward the base end side. After being applied force by the elastic member 158c, the cylindrical member 158a and the interlocking gear 158b are arranged at the base end position (first position) within the range of being able to move forward and backward. Figure 34 As shown, when the first upper and lower bending wire loading and unloading portion 151C is assembled to the driving device 200C, the base end of the cylindrical member 158a contacts the driving device 200C, thereby overcoming the reaction force of the elastic member 158c and pressing the cylindrical member 158a to the position on the base end side (the second position).

[0366] like Figure 33 As shown, when the interlocking gear 158b is in the first position, the interlocking gear 158b meshes with the first gear 156b and the second gear 157b. As a result, the first rotating drum 156 and the second rotating drum 157 rotate in conjunction with each other, and the first upper bending wire 161u and the first lower bending wire 161d are pulled or fed in conjunction with each other to form a loop (loop state).

[0367] like Figure 34 As shown, when the interlocking gear 158b is in the second position, the interlocking gear 158b is not engaged with the first gear 156b and the second gear 157b. As a result, the first rotating drum 156 and the second rotating drum 157 rotate independently, and the first upper bending wire 161u and the first lower bending wire 161d are independently pulled or fed (opposition state).

[0368] When the first upper and lower bending wire attachment and detachable portion 151C is not attached to the drive device 200C, the first rotating drum 156 and the second rotating drum 157 rotate in conjunction with each other. Specifically, when the interlocking gear 158b rotates counterclockwise when viewed from the distal end toward the proximal end, the first rotating drum 156 rotates clockwise, and the second rotating drum 157 also rotates clockwise. When the interlocking gear 158b rotates clockwise when viewed from the distal end toward the proximal end, the first rotating drum 156 rotates counterclockwise, and the second rotating drum 157 also rotates counterclockwise. Thus, even when the bending portion 112 is bent by an external force, the first upper bending wire 161u and the first lower bending wire 161d do not sag, maintaining the relationship between the rotation of the rotating drums (the first and second rotating drums 156, 157) and the bending of the bending portion 112 in the UD direction.

[0369] For example, even if the bending portion 112 bends due to some external force, pulling the first upper bending wire 161u toward the distal end and causing the first rotating drum 156 to rotate counterclockwise, the second rotating drum 157 also rotates counterclockwise in conjunction with the bending portion 112, winding up the first lower bending wire 161d that has become slack due to the bending of the bending portion 112. As a result, the bending wire 160 does not become slack.

[0370] [Drive device 200C]

[0371] Figure 35 This is a functional block diagram of the driving device 200C.

[0372] The driving device 200C includes an adapter 210C, an operation receiving unit 220 , an air supply and suction driving unit 230 , a wire driving unit 250C, and a driving controller 260C.

[0373] like Figure 32 As shown, the adapter 210C includes a first adapter 211 and a second adapter 212C. The first adapter 211 is an adapter detachably connected to the operation cable 301. The second adapter 212C is an adapter detachably connected to the first detachable portion 1503 of the endoscope 100C.

[0374] The wire driving unit 250C is coupled to the first vertical bending wire detachable unit 151C, the first horizontal bending wire detachable unit 152C, the second vertical bending wire detachable unit 153C, and the second horizontal bending wire detachable unit 154C to drive the bending wire 160 .

[0375] like Figure 32 As shown, the wire driving unit 250C includes a first vertical bending wire driving unit 251C, a first horizontal bending wire driving unit 252C, a second vertical bending wire driving unit 253C, and a second horizontal bending wire driving unit 254C.

[0376] The first vertical bending wire driving unit 251C is coupled to the first vertical bending wire detachable unit 151C and drives the wires (the first upward bending wire 161u and the first downward bending wire 161d) that bend the first bending portion 113 in the UD direction.

[0377] The first left-right bending wire driving unit 252C is a mechanism connected to the first left-right bending wire detachable unit 152C and drives the wires (the first left bending wire 1611 and the first right bending wire 161r) that bend the first bending portion 113 in the LR direction.

[0378] The second vertical bending wire driving unit 253C is a mechanism connected to the second vertical bending wire detachable unit 153C and drives the wires (the second upward bending wire 162u and the second downward bending wire 162d) that bend the second bending portion 114 in the UD direction.

[0379] The second left-right bending wire driving unit 254C is a mechanism connected to the second left-right bending wire detachable unit 154C and drives the wires (the second left bending wire 1621 and the second right bending wire 162r) that bend the second bending portion 114 in the LR direction.

[0380] The first left-right bending wire drive unit 252C, the second up-down bending wire drive unit 253C, and the second left-right bending wire drive unit 254C have the same structure as the first up-down bending wire drive unit 251C, and therefore, illustration and description thereof are omitted.

[0381] like Figure 33 As shown, the first upper and lower bending wire driving unit 251C includes a supporting member 255 , a first upper bending wire driving unit 256 , a first lower bending wire driving unit 257 , a coupling member 258 , and an attachment and detachment sensor 259 .

[0382] The first upper bending wire driving unit 256 is coupled to the first rotating drum 156 of the first upper and lower bending wire attaching and detaching unit 151C to drive the first upper bending wire 161u. The first upper bending wire driving unit 256 includes a first shaft 256a, a first motor unit 256b, a first coupled portion 256c, a first torque sensor 256e, a first engagement detection sensor 256f, and a first elastic member 256s.

[0383] The first shaft 256a is supported by the support member 255 so as to be rotatable about a first shaft rotation axis 256r and to be able to advance and retreat along the longitudinal direction A. When the first attachment and detachment portion 1503 of the endoscope 100C is attached to the drive device 200C, the first shaft rotation axis 256r coincides with the first roller rotation axis 156r.

[0384] The first motor unit 256b includes a first motor such as a DC motor, a first motor driver for driving the first motor, and a first motor encoder. The first motor rotates the first shaft 256a about a first shaft rotation axis 256r. The first motor driver is controlled by a drive controller 260C.

[0385] The first connected portion 256c is a circular plate member that rotates around the first shaft rotation axis 256r. The first connected portion 256c is fixed to the front end of the first shaft 256a and rotates integrally with the first shaft 256a. Figure 32 As shown, the first coupled portion 256c is exposed at the front end of the first vertical bending wire driving portion 251C. Two first fitting recesses 256d are formed on the front end surface of the first coupled portion 256c. The two first fitting recesses 256d are formed on either side of the first shaft rotation axis 256r.

[0386] like Figure 34 As shown, the first engaging protrusion 156d engages with the first engaging recess 256d, and the first coupling portion 156c couples with the first coupled portion 256c. As a result, the rotation of the first shaft 256a by the first motor unit 256b is transmitted to the first rotating drum 156. Clockwise rotation of the first shaft 256a, as viewed from the distal end toward the proximal end, pulls the first upper bending wire 161u. Conversely, counterclockwise rotation of the first shaft 256a causes the first upper bending wire 161u to be delivered.

[0387] The first torque sensor 256e detects the rotational torque of the first shaft 256a about the first shaft rotation axis 256r. The detection result of the first torque sensor 256e is obtained by the drive controller 260C.

[0388] The first fitting detection sensor 256f detects the fitting of the first fitting protrusion 156d and the first fitting recess 256d. Figure 34 As shown, the first coupled portion 256c is pressed into position by the first coupling portion 156c, thereby moving toward the base end (A2) along with the first shaft 256a. The first mating detection sensor 256f detects the mating of the first mating protrusion 156d and the first mating recess 256d by detecting the approach of the first mating detection protrusion 256g provided on the first shaft 256a. The detection results of the first mating detection sensor 256f are obtained by the drive controller 260C.

[0389] The first elastic member 256s is, for example, a compression spring, the front end of which contacts the first connected portion 256c, and the base end of which contacts the support member 255. The first elastic member 256s applies force to the first connected portion 256c toward the front end side (A1). Figure 33As shown, when the first coupling portion 156c is removed, the first coupled portion 256c moves toward the front end (A1) together with the first shaft 256a. As a result, the first engagement detection sensor 256f cannot detect engagement between the first engagement projection 156d and the first engagement recess 256d.

[0390] The first lower bending wire driving unit 257 is coupled to the second rotating drum 157 of the first upper and lower bending wire attaching and detaching unit 151C to drive the first lower bending wire 161d. The first lower bending wire driving unit 257 includes a second shaft 257a, a second motor unit 257b, a second coupled portion 257c, a second torque sensor 257e, a second engagement detection sensor 257f, and a second elastic member 257s.

[0391] The second shaft 257a is supported by the support member 255 so as to be rotatable about a second shaft rotation axis 257r and to be able to advance and retreat along the longitudinal direction A. When the first attachment and detachment portion 1501 of the endoscope 100C is attached to the drive device 200C, the second shaft rotation axis 257r coincides with the second roller rotation axis 157r.

[0392] The second motor unit 257b includes a second motor such as a DC motor, a second motor driver for driving the second motor, and a second motor encoder. The second motor rotates the second shaft 257a about the second shaft rotation axis 257r. The motor driver is controlled by the drive controller 260C.

[0393] The second coupled portion 257c is a circular plate member that rotates around the second shaft rotation axis 257r. The second coupled portion 257c is fixed to the front end of the second shaft 257a and rotates integrally with the second shaft 257a. Figure 32 As shown, the second coupled portion 257c is exposed at the front end of the first vertical bending wire driving portion 251C. Two second fitting recesses 257d are formed on the front end surface of the second coupled portion 257c. The two second fitting recesses 257d are formed on both sides of the second shaft rotation axis 257r.

[0394] like Figure 34 As shown, the second engaging protrusion 157d engages with the second engaging recess 257d, and the second coupling portion 157c couples with the second coupled portion 257c. As a result, the rotation of the second shaft 257a by the second motor unit 257b is transmitted to the second rotating drum 157. Counterclockwise rotation of the second shaft 257a, as viewed from the distal end toward the proximal end, pulls the first lower bending wire 161d. Conversely, clockwise rotation of the second shaft 257a causes the first lower bending wire 161d to be fed.

[0395] The second torque sensor 257e detects the rotational torque of the second shaft 257a about the second shaft rotation axis 257r. The detection result of the second torque sensor 257e is obtained by the drive controller 260C.

[0396] The second fitting detection sensor 257f detects the fitting of the second fitting protrusion 157d and the second fitting recess 257d. Figure 34 As shown, the second coupled portion 257c is pressed into position by the second coupling portion 157c, thereby moving toward the base end (A2) along with the second shaft 257a. The second mating detection sensor 257f detects the mating of the second mating protrusion 157d and the second mating recess 257d by detecting the approach of the second mating detection protrusion 257g provided on the second shaft 257a. The detection results of the second mating detection sensor 257f are obtained by the drive controller 260C.

[0397] The second elastic member 257s is, for example, a compression spring, the front end of which contacts the second connected portion 257c, and the base end of which contacts the support member 255. The second elastic member 257s applies force to the second connected portion 257c toward the front end side (A1). Figure 33 As shown, when the second coupling portion 157c is removed, the second coupled portion 257c moves toward the front end (A1) together with the second shaft 257a. As a result, the second fitting detection sensor 257f cannot detect the fitting between the second fitting protrusion 157d and the second fitting recess 257d.

[0398] like Figure 33 As shown, the coupling member 258 is a cylindrical member exposed at the front end side of the first vertical bending wire driving part 251C. Figure 34 As shown, when the first vertical bending wire attachment and detachable portion 151C is attached to the drive device 200C, the coupling member 258 contacts the base end of the cylindrical member 158a, thereby overcoming the reaction force of the elastic member 158c and pressing the cylindrical member 158a into the second position. As a result, the first rotating drum 156 and the second rotating drum 157 can rotate independently.

[0399] like Figure 34 As shown, the attachment / detachment sensor 259 detects the attachment / detachment of the first vertical bending wire detachable portion 151C relative to the first vertical bending wire driving portion 251C by detecting the engagement / disengagement with the attachment / detachment detection protrusion 155a. The detection result of the attachment / detachment sensor 259 is acquired by the driving controller 260C.

[0400] Figure 36 1 is a diagram showing the first vertical bending wire driving unit 251C equipped with the first vertical bending wire attaching and detaching unit 151C. Figure 36In the process, the attachment and detachment sensor 259 detects that the first vertical bending wire attachment and detachment portion 151C is attached to the first vertical bending wire driving portion 251C.

[0401] like Figure 36 As shown, when the first coupling portion 156c contacts the first coupled portion 256c but the first engaging protrusion 156d is not engaged with the first engaging recess 256d, the first engaging detection sensor 256f cannot detect the engagement of the first engaging protrusion 156d with the first engaging recess 256d. In this case, the drive controller 260C rotates the first coupled portion 256c to a position where the first engaging recess 256d and the first engaging protrusion 156d can engage. As a result, the first coupled portion 256c moves toward the front end side (A1) via the first elastic member 256s, thereby engaging the first engaging protrusion 156d with the first engaging recess 256d. The first engaging detection sensor 256f detects the engagement of the first engaging protrusion 156d with the first engaging recess 256d.

[0402] In the above-described mating operation, the drive controller 260C preferably rotates the first coupled portion 256c clockwise when viewed from the distal end toward the proximal end. Even if the first coupling portion 156c rotates due to contact friction between the first mating protrusion 156d and the first coupled portion 256c, the first winding wheel 156a rotates in the direction pulling the first upper bending wire 161u, thereby preventing the first upper bending wire 161u from becoming loose.

[0403] like Figure 36 As shown, when the second connecting portion 157c is in contact with the second connected portion 257c but the second engaging protrusion 157d is not engaged with the second engaging recess 257d, the drive controller 260C can also engage the second engaging protrusion 157d with the second engaging recess 257d by rotating the second connected portion 257c.

[0404] In the above-described mating operation, the drive controller 260C preferably rotates the second coupled portion 257c counterclockwise when viewed from the distal end toward the proximal end. Even if the second coupling portion 157c rotates due to contact friction between the second mating protrusion 157d and the second coupled portion 257c, the second winding wheel 157a rotates in the direction of pulling the first lower bending wire 161d, and therefore, the first lower bending wire 161d does not become loose.

[0405] The drive controller 260C compares the values ​​of the first torque sensor 256e and the second torque sensor 257e. If the value of the first torque sensor 256e is larger, the drive controller 260C rotates the first motor unit 256b and the second motor unit 257b to feed the first upper bending wire 161u and pull the first lower bending wire 161d.

[0406] On the other hand, when the value of the second torque sensor 257e is large, the drive controller 260C rotates the first motor unit 256b and the second motor unit 257b so as to pull the first upper bending wire 161u and feed the first lower bending wire 161d.

[0407] If the values ​​of the first torque sensor 256e and the second torque sensor 257e are equal, the drive controller 260C stops the first motor unit 256b and the second motor unit 257b. As a result, the tensions of the opposing wires (the first upper bending wire 161u and the first lower bending wire 161d) become equal, and the insertion portion 110 can be straightened.

[0408] The drive controller 260C refers to the values ​​of the first torque sensor 256e and the second torque sensor 257e. When the referenced values ​​are lower than predetermined torque sensor values, the drive controller 260C rotates the first motor unit 256b and the second motor unit 257b to pull the first upper bending wire 161u and the first lower bending wire 161d.

[0409] On the other hand, when the reference value is higher than the predetermined torque sensor value, the drive controller 260C rotates the first motor unit 256b and the second motor unit 257b so as to feed the first upper bending wire 161u and the first lower bending wire 161d.

[0410] If the values ​​of the first torque sensor 256e and the second torque sensor 257e are equal to the predetermined torque sensor values, the drive controller 260C stops the first motor unit 256b and the second motor unit 257b. As a result, the wire tension can be adjusted to the predetermined value.

[0411] With the above-described structure, when the first upper and lower bending wire attachment and detachment portion 151C is attached to the first upper and lower bending wire drive portion 251C, the first upper bending wire drive portion 256 can independently drive the first upper bending wire 161u, and the first lower bending wire drive portion 257 can independently drive the first lower bending wire 161d. Therefore, even when the distance from the bending portion 112 of the endoscope 100C to the drive device 200C is longer than that of conventional flexible endoscopes, slack during delivery due to wire extension during wire pulling is less likely to occur, and the bending operation of the bending portion 112 can be controlled with high precision.

[0412] The drive controller 260C controls the entire drive device 200C. The drive controller 260C receives the operation input received by the operation receiving unit 220. The drive controller 260C controls the air supply and suction drive unit 230 and the wire drive unit 250C based on the received operation input.

[0413] The drive controller 260C is a computer that includes a processor, memory, a storage unit capable of storing programs and data, and an input / output control unit. The functions of the drive controller 260C are implemented by the processor executing the program. Alternatively, at least some of the functions of the drive controller 260C may be implemented by dedicated logic circuits.

[0414] The drive controller 260C is expected to have high computational performance so as to accurately control the plurality of motors that drive the plurality of bending wires 160 .

[0415] Next, a method of using the electric endoscope system 1000C of this embodiment will be described. Specifically, a surgical procedure for observing and treating an affected area formed on the tube wall in the large intestine using the electric endoscope system 1000C will be described.

[0416] The surgeon S inserts the insertion portion 110 of the endoscope 100C from the front end through the anus of the patient P into the large intestine. Figure 2 As shown, the surgeon S operates the internal soft part 119 with his right hand R while observing the captured image displayed on the display device 900 , thereby moving the insertion portion 110 and bringing the distal end portion 111 close to the affected area.

[0417] Figure 37 100C is a diagram showing an example of use of the bending portion 112 of the electric endoscope system 1000C.

[0418] The surgeon S sets the bending mode to the second bending portion control mode M2. The surgeon S operates the first angle knob 320 to pull the second upper bending line 162u and send out the second lower bending line 162d. In addition, the surgeon S operates the second angle knob 330 to pull the second left bending line 162l and send out the second right bending line 162r. As a result, Figure 37 As shown, the second curved portion 114 is greatly curved to form a so-called "J-shaped turn" shape.

[0419] The electric endoscope system 1000C can independently drive the pair of bending wires that bend the bending portion 112 in the UD direction, pulling one while advancing the other. Furthermore, the electric endoscope system 1000C can independently drive the pair of bending wires that bend the bending portion 112 in the LR direction, pulling one while advancing the other, eliminating any slack. Therefore, compared to the electric endoscope system 1000 of the first embodiment, the electric endoscope system 1000C can accurately bend the bending portion 112 without delay.

[0420] When the second curved portion 114 is bent and Figure 37 When the second curved portion 114 is brought into contact with the opposing large intestinal wall 1W as shown, even if air is expelled, the second curved portion 114 can maintain contact with the opposing large intestinal wall 1W to ensure space. In this state, the surgeon S can independently move the first curved portion 113 located at the distal end of the fixed second curved portion 114. Therefore, while ensuring space with the second curved portion 114, the surgeon S can manipulate the first curved portion 113 and thus the treatment portion 410 of the treatment instrument 400, making it easier to treat the affected area.

[0421] According to the electric endoscope system 1000C of this embodiment, observation or treatment using the endoscope 100C can be performed more efficiently. The drive mechanism for driving the bending portion 112 is not located in the operating device 300 but in the drive device 200C. Therefore, a dedicated bending wire drive unit can be provided for each bending wire 160. The drive controller 260C can independently drive each bending wire 160, enabling high-precision control of the bending operation of the bending portion 112.

[0422] According to the electric endoscope system 1000C of this embodiment, when the loading and unloading portion 150C of the endoscope 100C is not assembled on the driving device 200C, a pair of bending lines corresponding to the UD direction or the LD direction becomes a loop state. For example, even if the bending portion 112 is bent by some external force and any bending line 160 is pulled toward the front end side, the bending line 160 will not become loose.

[0423] According to the electric endoscope system 1000C of this embodiment, when the loading and unloading portion 150C of the endoscope 100C is assembled on the driving device 200C, a pair of bending wires corresponding to the UD direction or LD direction are independently pulled or sent out (antagonistic state) without performing any additional operation.

[0424] The third embodiment of the present invention has been described in detail with reference to the accompanying drawings, but the specific structure is not limited to this embodiment and includes design changes within the scope of the present invention. In addition, the structural elements shown in the above-mentioned embodiment and modification examples can be appropriately combined and configured.

[0425] (Variation 3-1)

[0426] In the above embodiment, the connecting member 158 connects the first rotating drum 156 and the second rotating drum 157 via the interlocking gear 158b. However, the configuration of the connecting member 158 is not limited to this. For example, the interlocking gear 158b may be constantly connected to the first rotating drum 156, while the interlocking gear 158b may be connected or disconnected from the second rotating drum 157. Furthermore, for example, the connecting member 158 may connect the first rotating drum 156 and the second rotating drum 157 via a belt, and when the belt is connected, the idler pulley that tensions the belt is disengaged, thereby disconnecting the first rotating drum 156 and the second rotating drum 157.

[0427] (Variation 3-2)

[0428] In the above embodiment, the driving device 200C of the electric endoscope system 1000C drives the endoscope 100C. However, the driving device 200C is not limited thereto and may also drive medical equipment such as a robotic arm.

[0429] (Fourth embodiment)

[0430] Reference Figures 38 to 42 A fourth embodiment of the present invention is described with respect to an electric endoscope system 1000D. In the following description, the same reference numerals are given to the same components as those already described, and redundant descriptions are omitted. Figure 38 It is an overall view of an electric endoscope system 1000D according to this embodiment.

[0431] [Electric Endoscope System 1000D]

[0432] like Figure 38 As shown in FIG, the electric endoscope system 1000D is a medical system for observing and treating the body of a patient P lying on an operating table T. The electric endoscope system 1000D includes an endoscope 100D, a driving device 200, an operating device 300, a treatment instrument 400, an image control device 500, and a display device 900. Figure 38 The operating device 300 is shown without the second forceps jaw fixing device 360 ​​installed.

[0433] [Endoscope 100D]

[0434] like Figure 38 As shown, the endoscope 100D includes an insertion portion 110, a connecting portion 120D, an external flexible portion 140, a detachable portion 150, a bending wire 160, and an internal component 170. The insertion portion 110, the connecting portion 120D, the external flexible portion 140, and the detachable portion 150 are connected in order from the distal end. The connecting portion 120D can be connected to the extension channel tube 130.

[0435] [Connection portion 120D]

[0436] The connecting portion 120D connects the internal soft portion 119 and the external soft portion 140 of the insertion portion 110. The connecting portion 120D includes a cylindrical member 121, a connecting portion body 122, a sealing portion 123, a bearing portion 124D, a cover member 125, a forceps opening 126, and a three-pronged pipe 127.

[0437] Figure 39 It is a perspective view of the cylindrical member 121 and the bearing portion 124D.

[0438] The bearing portion 124D connects the connecting portion body 122 and the cylindrical member 121 so that they can rotate around the rotation axis extending along the longitudinal direction A. Specifically, the bearing portion 124D is fixed to the connecting portion body 122. The bearing portion 124D supports the cylindrical member 121 so that it can rotate around the rotation axis extending along the longitudinal direction A.

[0439] Figure 40 It is an exploded perspective view of the cylindrical member 121 and the bearing portion 124D.

[0440] The bearing portion 124D includes a first bearing member 124a, a first screw 124c, a second bearing member 124d, and a second screw 124f.

[0441] The first bearing member 124a is formed in a cylindrical shape. The inner circumferential surface of the first bearing member 124a engages with the outer circumferential surface of the cylindrical member 121. A first groove 124b is formed in the first bearing member 124a, extending along the circumferential direction C. The first groove 124b extends through the first bearing member 124a in the radial direction R. The length of the first groove 124b in the circumferential direction C is approximately ¾ of the circumference.

[0442] The first screw 124c is attached to the outer circumferential surface of the cylindrical member 121 and extends through the first groove 124b. The first screw 124c limits the rotation angle of the first bearing member 124a in the circumferential direction C. The position of the first bearing member 124a, where the first screw 124c is positioned in the middle of the first groove 124b, is referred to as the "first reference position." The first bearing member 124a can rotate within ±135 degrees in the circumferential direction C relative to the first reference position.

[0443] The second bearing member 124d is formed in a cylindrical shape. The outer circumferential surface of the second bearing member 124d is fixed to the connecting portion body 122. The inner circumferential surface of the second bearing member 124d is engaged with the outer circumferential surface of the first bearing member 124a. A second groove 124e extending along the circumferential direction C is formed in the second bearing member 124d. The second groove 124e extends through the second bearing member 124d in the radial direction R. The length of the second groove 124e in the circumferential direction C is approximately ¾ of the circumference.

[0444] The second screw 124f is a screw mounted on the outer circumferential surface of the first bearing member 124a and extends through the second groove 124e. The second screw 124f is located on the opposite side of the first screw 124c across the center axis O in the longitudinal direction A in the first bearing member 124a, which is located at the first reference position. The second bearing member 124d is limited in its rotation angle in the circumferential direction C by the second screw 124f. The position of the second bearing member 124d, where the second screw 124f is located in the middle of the second groove 124e, is defined as the "second reference position." The second bearing member 124d can rotate up to ±135 degrees in the circumferential direction C based on the second reference position.

[0445] The position of the bearing portion 124D where the first bearing member 124a is located at the first reference position and the second bearing member 124d is located at the second reference position is referred to as the “reference position.” The bearing portion 124D is rotatable up to ±270 degrees in the circumferential direction C with respect to the reference position.

[0446] Next, a method of using the electric endoscope system 1000D of this embodiment will be described. Specifically, a surgical procedure for observing and treating an affected area formed on the tube wall in the large intestine using the electric endoscope system 1000D will be described.

[0447] Figure 41 1000D is a diagram showing treatment using the electric endoscope system 1000D.

[0448] Surgeon S inserts the insertion portion 110 of endoscope 100D from the distal end through the anus of patient P into the large intestine. While observing the camera image displayed on the display device 900, surgeon S uses his right hand R to manipulate the internal soft portion 119, moving the insertion portion 110 so that the distal end portion 111 approaches the affected area. Surgeon S also uses his left hand L to manipulate the first and second angle knobs 320 and 330 of the operating device 300 to bend the bending portion 112 as needed.

[0449] The assistant AS grasps the proximal end of the extension channel tube 130. The assistant AS inserts the treatment instrument 400 from the proximal end opening and passes the treatment instrument 400 through the extension channel tube 130 and the forceps opening 126 into the channel tube 171. The assistant AS operates the treatment instrument 400 while observing the image displayed on the display device 900.

[0450] Since the operating device 300 is separated from the forceps opening 126 and the extension channel tube 130 for inserting the treatment instrument 400, the surgeon S can focus on operating the insertion portion 110 of the endoscope 100D, while the assistant AS can focus on operating the treatment instrument 400. The surgeon S and the assistant AS can operate the insertion portion 110 and the treatment instrument 400 without closely coordinating their movements.

[0451] The electric endoscope system 1000D of this embodiment enables more efficient observation or treatment using the endoscope 100D. Since the endoscope 100D is separate from the operating device 300, the surgeon S can operate the endoscope 100D and the operating device 300 independently without affecting each other.

[0452] When the surgeon S rotates the internal flexible portion 119 of the insertion portion 110 about the rotation axis extending along the longitudinal direction A, only the internal flexible portion 119 can be rotated. Therefore, the surgeon S can easily perform rotational manipulation of the internal flexible portion 119. Furthermore, since the endoscope 100D is separate from the operating device 300, there is no need to coordinate the operation of the operating device 300 with the rotation (twisting) of the internal flexible portion 119. Consequently, the surgeon S is not forced into unreasonable musculoskeletal postures and is less likely to become fatigued.

[0453] On the other hand, unless the surgeon S rotates the internal soft portion 119 of the insertion portion 110, the internal soft portion 119 does not rotate relative to the external soft portion 140. Therefore, even if the surgeon S removes his right hand R from the internal soft portion 119 to operate the treatment instrument 400, the internal soft portion 119 does not rotate relative to the external soft portion 140.

[0454] The bearing 124D restricts rotation to ±270 degrees with respect to the reference position in the circumferential direction C. Therefore, the bearing 124D is prevented from rotating unrestricted relative to the cylindrical member 121 and the internal soft portion 119 and causing the internal object 170 to twist significantly.

[0455] like Figure 8As shown, the forceps opening 126 for inserting the treatment instrument 400 is provided on the cover member 125 in the connecting portion 120D. Even if the internal soft part 119 rotates about the rotation axis extending along the longitudinal direction A, the forceps opening 126 does not rotate. Therefore, even if the surgeon S rotates the internal soft part 119, the assistant AS can stably operate the treatment instrument 400.

[0456] The operating device 300 is separated from the extension channel tube 130 into which the treatment instrument 400 is inserted. Therefore, the extension channel tube 130 can be disposed of as a consumable (disposable) item after surgery. Treating the extension channel tube 130 as a consumable item reduces the number of areas of surgical clothing that require cleaning in the electric endoscope system 1000D.

[0457] The fourth embodiment of the present invention has been described in detail with reference to the accompanying drawings, but the specific structure is not limited to this embodiment and includes design changes within the scope of the present invention. In addition, the structural elements shown in the above-mentioned embodiments and modifications can be appropriately combined and configured.

[0458] (Variation 4-1)

[0459] In the above embodiment, the connection portion 120D connecting the internal flexible portion 119 and the external flexible portion 140 is provided in a portion of the endoscope 100D. However, the form of the connection portion 120D is not limited to this. Figure 42 The figure shows a connection portion 120DA, which is a modified example of the connection portion 120D. The connection portion (rotation retaining portion, external connection portion) 120DA holds the connection portion between the internal flexible portion 119 and the external flexible portion 140. The connection portion 120DA supports the connection portion between the internal flexible portion 119 and the external flexible portion 140 so that it can rotate freely about a rotation axis extending along the longitudinal direction A. Therefore, when the surgeon S rotates the internal flexible portion 119 of the insertion portion 110 about the rotation axis extending along the longitudinal direction A, the internal flexible portion 119 and the external flexible portion 140 are allowed to rotate in conjunction. In addition, because the connection portion 120DA has friction, the position rotated about the rotation axis extending along the longitudinal direction A is maintained even if the hand is removed from the insertion portion. The arm 129 can easily switch between fixed and free movement, so the position of the arm 129 can be changed according to the progress of insertion into the body.

[0460] The connecting portion 120DA may include an electric unit capable of advancing and retreating the internal soft portion 119 and the external soft portion 140 along the longitudinal direction A. The surgeon S can advance and retreat the internal soft portion 119 by electric control without directly operating the internal soft portion 119 with his right hand R.

[0461] (Variation 4-2)

[0462] In the above embodiment, the treatment instrument 400 is operated by an assistant AS. In the first embodiment, the treatment instrument 400 is operated by the surgeon S. However, the operation method of the treatment instrument 400 is not limited to this. A treatment instrument advancement and retraction device that electrically advances and retracts the treatment instrument 400 may also be used to assist in the operation of the treatment instrument 400. The treatment instrument advancement and retraction device is appropriately selected from among known advancement and retraction devices capable of advancing and retracting the treatment instrument 400. The use of the treatment instrument advancement and retraction device can reduce the burden on the surgeon S and assistant AS, and can also accurately advance and retract the treatment instrument 400.

[0463] (Fifth embodiment)

[0464] Reference Figures 43 to 48 A fifth embodiment of the present invention is described with respect to an electric endoscope system 1000E. In the following description, the same reference numerals are given to the same components as those already described, and duplicate descriptions are omitted. Figure 43 It is an overall view of an electric endoscope system 1000E according to this embodiment.

[0465] [Electric Endoscope System 1000E]

[0466] like Figure 43 As shown, the electric endoscope system 1000E is a medical system for observing and treating the body of a patient P lying on an operating table T. The electric endoscope system 1000E includes an endoscope 100E, a driving device 200 , an operating device 300 , a treatment instrument 400 , an image control device 500 , and a display device 900 .

[0467] [Endoscope 100E]

[0468] like Figure 43 As shown, the endoscope 100E includes an insertion portion 110E, a connecting portion 120, an external flexible portion 140E, a detachable portion 150, a bending wire 160, and an internal component 170. The insertion portion 110E, the connecting portion 120, the external flexible portion 140E, and the detachable portion 150 are connected in order from the distal end side.

[0469] [Insertion section 110E]

[0470] The insertion portion 110E is a long, thin member that can be inserted into a lumen. The insertion portion 110E includes a distal end portion 111, a curved portion 112, and an internal flexible portion 119E. The distal end portion 111, the curved portion 112, and the internal flexible portion 119E are connected in sequence from the distal end side.

[0471] Figure 44It is a cross-sectional view of the internal soft part 119E.

[0472] The internal soft portion 119E is a long, flexible tubular member, and a bending wire 160 , a channel tube 171 , an imaging cable 173 , and a light guide 174 are inserted through an internal path 101 formed in the internal soft portion 119E.

[0473] [External soft part 140E]

[0474] Figure 45 4 is a cross-sectional view of the external soft portion 140E.

[0475] The external flexible portion 140E is a long tubular member, and a bending wire 160 , an air supply and suction tube 172 , an imaging cable 173 , and a light guide 174 are inserted through an internal path 101 formed inside the external flexible portion 140E.

[0476] The bending wires 160 inserted through the internal path 101 formed in the internal flexible portion 119E and the external flexible portion 140E are a first bending wire 161 for bending the first bending portion 113 and a second bending wire 162 for bending the second bending portion 114 .

[0477] The first wire sheath 161s through which the first upper bending wire 161u is inserted and the first wire sheath 161s through which the first lower bending wire 161d is inserted are bound together at at least one position by the fastener 163. Figure 6 As shown, the first upper bending line 161u and the first lower bending line 161d are arranged on both sides of the central axis O in the UD direction in the first bending portion 113, but are arranged adjacent to each other in the internal flexible portion 119E and the external flexible portion 140E.

[0478] The first wire sheath 161s through which the first left-bending wire 1611 is inserted and the first wire sheath 161s through which the first right-bending wire 161r is inserted are bound together at at least one position by the fastener 163. Figure 6 As shown, the first left bending line 1611 and the first right bending line 161r are arranged on both sides of the central axis O in the LR direction in the first bending portion 113, but are arranged adjacent to each other in the internal flexible portion 119E and the external flexible portion 140E.

[0479] The second wire sheath 162s through which the second upper curved wire 162u is inserted and the second wire sheath 162s through which the second lower curved wire 162d is inserted are bound together at at least one position by the fastener 163. Figure 7 As shown, the second upper bending line 162u and the second lower bending line 162d are arranged on both sides of the central axis O in the UD direction in the second bending portion 114, but are arranged adjacent to each other in the internal flexible portion 119E and the external flexible portion 140E.

[0480] The second wire sheath 162s through which the second left-bend wire 162l is inserted and the second wire sheath 162s through which the second right-bend wire 162r is inserted are bound together at at least one position by the fastener 163. Figure 7 As shown, the second left bending line 1621 and the second right bending line 162r are arranged on both sides of the central axis O in the LR direction in the second bending portion 114, but are arranged adjacent to each other in the internal flexible portion 119E and the external flexible portion 140E.

[0481] In the following description, when the first wire sheath 161s and the second wire sheath 162s are not particularly distinguished from each other, they are referred to as a "wire sheath 160s".

[0482] Figure 46 This is a diagram showing two bundled wire sheaths 160s.

[0483] The two wire sheaths 160s are bound together by a plurality of fasteners 163. The fasteners 163 for binding the two wire sheaths 160s are arranged at predetermined intervals P from the distal end side (A1) to the proximal end side (A2).

[0484] The fastener 163 is formed in an annular shape and is arranged along the circumferential direction C of the two wire sheaths 160s. The two wire sheaths 160s are inserted through the fastener 163. Therefore, the fastener 163 binds the two wire sheaths 160s together in a direction perpendicular to the longitudinal direction A so that they do not separate.

[0485] The fastener 163 is fixed to one of the two wire sheaths 160s (counter sheaths) by caulking, soldering, or heat shrinking. On the other hand, the fastener 163 is not fixed to the other of the two wire sheaths 160s (counter sheaths). Therefore, the other wire sheath 160s (counter sheath) can move forward and backward in the longitudinal direction A and rotate around the circumferential direction C relative to the fastener 163.

[0486] Figure 47 It is a cross-sectional view of the curved internal flexible portion 119E and the external flexible portion 140E.

[0487] When the internal flexible portion 119E and the external flexible portion 140E are bent, the two wire sheaths 160s (pair of sheaths) bound by the fastener 163 have similar curved shapes. The two bending wires 160 inserted through the two wire sheaths 160s (pair of sheaths) also have similar curved shapes.

[0488] One end of the sheath is fixed to the fastener 163, but the other end is not fixed to the fastener 163. Therefore, even if a difference in the inner and outer sheath wheel occurs when the internal flexible portion 119E and the external flexible portion 140E are bent, the other end of the sheath moves relative to the fastener 163, and thus the wire sheath 160s does not twist or deform.

[0489] The two wires inserted through the counter sheath are a pair of opposing bending wires 160 (opposing wires) that bend the bending portion 112 in the UD or LR directions. Therefore, even when the opposing wires are inserted through a long path extending from the insertion portion 110E to the internal flexible portion 119E and the external flexible portion 140E of the drive device 200, the bending shapes of the opposing wires remain similar. As a result, the drive controller 260 can easily estimate the tension (tension difference, tension ratio, etc.) of the opposing wires, making it easier to accurately bend the bending portion 112.

[0490] Figure 48 This is a diagram showing an insertion portion 110E inserted into the large intestine.

[0491] In particular, the pair of sheaths inserted through the internal flexible portion 119E are preferably bound at intervals P that match the assumed curved shape by the fasteners 163. The internal flexible portion 119E inserted into the large intestine passes through a large curvature region RB1 that curves at a large angle (α1) and a small curvature region RB2 that curves at a smaller angle (α2) than the large curvature region RB1.

[0492] It is assumed that when treating an affected area, the opposing sheaths placed in the large bending region RB1 are preferably bounded by fasteners 163 at relatively narrow intervals P. In the large bending region RB1, this can limit the sheaths from bending significantly, preventing a decrease in the transmission efficiency of the opposing wires. When the opposing sheaths are bounded by fasteners 163 at relatively wide intervals P in the large bending region RB1, the opposing wires tend to have different curved shapes. On the other hand, when the opposing sheaths are bounded by fasteners 163 at relatively narrow intervals P in the large bending region RB1, the curved shapes of the opposing wires are similar, making it easier to estimate the tension of the opposing wires.

[0493] It is assumed that when treating the affected part, the counter sheath placed in the small bending region RB2 is preferably bound by the fastener 163 at a wider interval P. Since the counter sheath is not assumed to bend significantly in the small bending region RB2, it is desirable to further increase the interval P to reduce the influence of the fastener 163 itself on the transmission of the counter wire.

[0494] The electric endoscope system 1000E of this embodiment enables more efficient observation or treatment using the endoscope 100E. Since the endoscope 100E is separate from the operating device 300, the surgeon S can operate the endoscope 100E and the operating device 300 independently without affecting each other.

[0495] As the driving device 200 is separated from the operating device 300, the path of the bending line 160 of the endoscope 100E from the insertion part 110E to the driving device 200 sometimes becomes longer, but the driving controller 260 can easily estimate the tension of the opposing lines (tension difference, tension ratio, etc.) and easily bend the bending part 112 accurately.

[0496] The fifth embodiment of the present invention has been described in detail with reference to the accompanying drawings, but the specific structure is not limited to this embodiment and includes design changes within the scope of the present invention. In addition, the structural elements shown in the above-mentioned embodiments and modifications can be appropriately combined and configured.

[0497] (Variation 5-1)

[0498] In the above embodiment, the bending portion 112 has a bending function (multi-stage bending function) in which the first bending portion 113 and the second bending portion 114 bend in two stages. However, the bending portion 112 is not limited to this. The bending portion 112 may have only the second bending portion 114 without the first bending portion 113. The bending portion 112 may also have a third bending portion, allowing it to bend in three stages.

[0499] (Variation 5-2)

[0500] In the above embodiment, one side of the sheath is fixed to the fastener 163, but the other side of the sheath is not fixed to the fastener 163. However, the fixing method of the sheath is not limited to this. Both sides of the sheath may be fixed to the fastener 163. In addition, neither side of the sheath may be fixed to the fastener 163.

[0501] (Variation 5-3)

[0502] In the above embodiment, the wire sheath 160s inserted through the internal flexible portion 119E and the external flexible portion 140E is bound by the fastener 163. However, the method of binding the wire sheath 160s is not limited to this. Alternatively, only a portion of the wire sheath 160s inserted through the internal flexible portion 119E and the external flexible portion 140E may be bound by the fastener 163.

[0503] (Variation 5-4)

[0504] In the above embodiment, the sheath is bound by the annular fastener 163. However, the form of the fastener 163 is not limited to this. Figure 49 163B is a diagram showing a modified example of the fastener 163. The fastener (third wire sheath) 163B is longer in the longitudinal direction A than the fastener 163 and is formed in a sheath shape.

[0505] (Variation 5-5)

[0506] In the above embodiment, the two wire sheaths 160s (pair of sheaths) are separated and bound together by the fastener 163. However, the form of the two wire sheaths 160s (pair of sheaths) is not limited to this. Figure 50 16 is a diagram showing a pair sheath 161B as a modified example of the two wire sheaths 160s (pair sheath). In the pair sheath 161B, the two wire sheaths 160s are integrally formed.

[0507] (Sixth embodiment)

[0508] When the electric endoscope system includes functions such as the coordinated bending control mode M5, the cost tends to increase, and thus the price of the electric endoscope system tends to increase. Therefore, users (hospitals) may hesitate to introduce the electric endoscope system.

[0509] A sixth embodiment of the present invention provides an electric endoscope system that enables the use of a function such as the coordinated bending control mode M5 only when it is necessary, and generates billing information when the function is available, such as for billing purposes. This reduces the cost of acquiring the electric endoscope system for the user. Hereinafter, functions subject to billing are referred to as additional functions.

[0510] Reference Figure 51 A billing system 2000 including the electric endoscope system according to the sixth embodiment will be described. Figure 51 This is an overall diagram of the billing system 2000 according to this embodiment.

[0511] [Billing System 2000]

[0512] like Figure 51 As shown, the billing system 2000 includes a billing server SV1 , a hospital server SV2 , and an electric endoscope set 2100 .

[0513] [Billing Server SV1]

[0514] Billing server SV1 manages information used for billing. Billing server SV1 is a computer equipped with a processor, memory, a storage unit capable of storing programs and data, and an input / output control unit capable of executing programs. The functions of billing server SV1 are implemented by the processor executing the program. At least some of the functions of billing server SV1 may also be implemented by dedicated logic circuitry.

[0515] The billing server SV1 and the hospital server SV2 communicate with each other via the external network NW1 and the internal network NW2. For example, the external network NW1 is the Internet. For example, the internal network NW2 is a LAN (Local Area Network) established within the hospital. The billing server SV1 communicates with the electric endoscope set 2100 via the external network NW1 and the internal network NW2, receiving information related to the use of additional functions. Based on the received information, the billing server SV1 performs billing processing.

[0516] [Hospital Server SV2]

[0517] Hospital server SV2 is included in the hospital's internal system and manages electronic medical records and other information. Hospital server SV2 is a computer equipped with a processor, memory, a storage unit capable of storing programs and data, and an input / output control unit capable of executing programs. The functions of hospital server SV2 are implemented by the processor executing the program. At least some of the functions of hospital server SV2 may also be implemented by dedicated logic circuitry.

[0518] [Electric Endoscope Set 2100]

[0519] The electric endoscope assembly 2100 includes multiple electric endoscope systems. For example, the electric endoscope assembly 2100 includes an electric endoscope system including a control device 600a and endoscope 100a, an electric endoscope system including a control device 600b and endoscope 100b, an electric endoscope system including a control device 600c and endoscope 100c, and endoscope 100d. The control device 600a and endoscope 100a are used in treatment room RM100, the control device 600b and endoscope 100b are used in treatment room RM101, and the control device 600c and endoscope 100c are used in treatment room RM102. Endoscope 100d is not used.

[0520] The control device 600a, the control device 600b and the control device 600c have Figure 26 The endoscope 100a, the endoscope 100b and the endoscope 100c have the same structure as the control device 600B shown in FIG. Figure 1The endoscope 100 shown in FIG. 1 has the same structure as the endoscope 100 shown in FIG. Endoscope 100a is connected to a control device 600a. Endoscope 100a can also be connected to a control device 600b or a control device 600c. Endoscope 100b is connected to a control device 600b. Endoscope 100b can also be connected to a control device 600a or a control device 600c. Endoscope 100c is connected to a control device 600c. Endoscope 100c can also be connected to a control device 600a or a control device 600b. When endoscope 100d is used, endoscope 100d is connected to any one of the control devices 600a, 600b, and 600c. In each electric endoscope system, structures other than the control device and the endoscope are not shown.

[0521] Hereinafter, as an electric endoscope system included in the electric endoscope group 2100, Figure 26 Hereinafter, the control device 600B is used instead of the control device 600a, the control device 600b, and the control device 600c.

[0522] Not shown is the hospital network to which the hospital server SV2 and the electric endoscope set 2100 are connected. Not shown are personal computers (PCs) and the like connected to the hospital network.

[0523] The following describes the functions of the billing system 2000. The sixth embodiment is not limited to the following example.

[0524] The drive controller 260B included in the drive device 200B detects the state of the selector switch 340B and transmits status information indicating this state to the processor 561 of the image control device 500 included in the control device 600B. The processor 561 receives the status information from the drive controller 260B and, based on this information, detects the bending mode of the bending portion 112. If the bending mode is a mode that uses an additional function, the processor 561 generates usage status information indicating the use of the additional function. The usage status information is billing information used for billing purposes.

[0525] The electric endoscope system 1000B has two or more functions, including basic functions and additional functions. For example, the mode using the basic functions is the simulated single bending control mode M4. For example, the mode using the additional functions is at least one of the first bending section control mode M1, the second bending section control mode M2, the coordinated bending control mode M5, and the simulated single bending transition mode M6. The modes included in the basic and additional functions can be combined through settings, and the manufacturer can freely set the modes included in each function. Basic functions are not subject to billing, while additional functions are subject to billing.

[0526] Processor 561 is communicatively connected to billing server SV1. Processor 561 outputs the generated usage status information to input / output control unit 564 of image control device 500 included in control device 600B. Input / output control unit 564 includes a communication circuit and is connected to internal network NW2. I / O control unit 564 communicates with billing server SV1 via internal network NW2 and external network NW1, transmitting usage status information to billing server SV1. Billing server SV1 receives the usage status information from I / O control unit 564 and performs billing processing based on the usage status information.

[0527] The processor 561 may also record a system log including usage status information in the memory 562 of the image control device 500 included in the control device 600B. For example, when performing maintenance on the electric endoscope system 1000B, a maintenance operator may retrieve the system log from the memory 562. In this case, the input / output control unit 564 does not need to transmit the usage status information to the billing server SV1.

[0528] In a system where billing is determined solely by the number of times or duration of additional functions used, surgeon S may expedite the surgical procedure to minimize the number or duration of additional functions used. In the following example, even if an additional function is used more than twice to observe or treat a single case, the billing amount remains the same as if it were used once. Therefore, the likelihood of surgeon S expediting the surgical procedure to minimize the billing amount is reduced. Each case is associated with a patient. Treatment of a case can also include surgery.

[0529] Many cases may be observed or treated in a single day. Furthermore, some cases require additional functions, while others do not, necessitating accurate recording of the usage of these functions. During the observation or treatment of a single case, the surgeon S may switch the power of the electric endoscope system 1000B on and off. Alternatively, the surgeon S may remove and reinstall the endoscope 100 during the observation or treatment of a single case. However, the processor 561 is capable of detecting these changes and generating usage information for each case, regardless of these factors.

[0530] Processor 561 generates a case identification code. One case identification code is assigned to one case. Case identification codes are unique across multiple cases. Processor 561 associates the case identification code with usage information and stores the case identification code and usage information in memory 562.

[0531] The processor 561 is connected to the hospital server SV2 in a communicative manner. The input / output control unit 564 communicates with the hospital server SV2 via the internal network NW2 and receives a predetermined identification code for identifying the case. Alternatively, the input / output control unit 564 obtains a predetermined identification code input into an input device (e.g., a keyboard) not shown. The predetermined identification code is a patient ID, a date ID, or a test order ID prepared in the hospital. The input / output control unit 564 outputs the predetermined identification code to the processor 561. The processor 561 generates a case identification code based on the predetermined identification code, thereby obtaining the case identification code.

[0532] The processor 561 can detect changes in the case by detecting changes in the identification code provided by the hospital. By combining two or more identification codes, the processor 561 can accurately detect changes in the case. For example, in addition to using the above-mentioned ID, the endoscope ID assigned to each endoscope 100 can also be used. Sometimes two or more different endoscopes 100 are used for the same patient. For example, the endoscope 100 used for upper gastrointestinal examination and the endoscope 100 used for lower gastrointestinal examination are different from each other. In the case where the patient ID does not change but the endoscope ID changes, the processor 561 can detect changes in the case. It is also possible to set the usage period of the identification code provided by the hospital, and the identification code becomes invalid after the usage period has expired.

[0533] For example, after observation or treatment of a case is performed, cleaning of the endoscope 100 is performed. In a system that records the history of the cleaning, an identification code corresponding to the history may be used.

[0534] By using the endoscope ID or the like in addition to the identification code provided by the hospital or by setting a usage period for the identification code provided by the hospital, it is possible to suppress unauthorized use of the identification code provided by the hospital.

[0535] The billing method is determined based on the type of contract concluded between the provider and the user of the electric endoscope system 1000B. The processor 561 suppresses communication via the internal network NW2 while observation or treatment is being performed.

[0536] For example, contract types include comprehensive contracts, pay-as-you-go contracts, and long-term contracts. With a comprehensive contract, the fee is fixed for the entire contract period, regardless of whether additional features are used. With a pay-as-you-go contract, if additional features are used for a particular case, a billing amount will be generated for the use of the additional features. When the contract period of a comprehensive or pay-as-you-go contract expires, the user cannot use the additional features. With a long-term contract, no billing amount will be generated even if additional features are used. Contract information indicating the contract type is recorded in memory 562.

[0537] Users who have signed a long-term contract can also attach a hardware dongle to the image control device 500. The processor 561 can also detect the hardware dongle via the input / output control unit 564 and determine that the contract type is a long-term contract. In the case of a long-term contract, usage information can also be recorded in the system log.

[0538] The electric endoscope system 1000B outputs billing information corresponding to the user's usage of the endoscope 100. The processor 561 obtains a case identification code corresponding to the case in which the endoscope 100 was used. The processor 561 detects whether the function subject to billing is being used. If billing information associated with the case identification code has already been generated, the processor 561 does not generate new billing information associated with the case identification code. If the function subject to billing is detected to be in use and no billing information associated with the case identification code has been generated, the processor 561 generates and outputs new billing information associated with the case identification code.

[0539] Reference Figure 52 and Figure 53 , explaining the processing used for billing. Figure 52 and Figure 53 is a flowchart showing the steps of a process performed by the processor 561.

[0540] When the electric endoscope system 1000B is started, the processor 561 starts Figure 52 The processor 561 refers to the contract information recorded in the memory 562 to confirm the type of contract (step S100). The processor 561 may also cause the input / output control unit 564 to communicate with the hospital server SV2 to receive the contract information from the hospital server SV2.

[0541] In step S100, if the contract type is a pay-as-you-go contract, step S105 is executed. In step S100, if the contract type is a comprehensive contract or a long-term contract, Figure 52 The indicated processing ends.

[0542] In step S100, if the contract type is a pay-as-you-go contract, processor 561 causes input / output control unit 564 to communicate with hospital server SV2, and receives a predetermined identification code A provided by the hospital from hospital server SV2. Processor 561 obtains identification code A received by input / output control unit 564 from input / output control unit 564 (step S105).

[0543] In step S100, if the contract type is a pay-as-you-go contract, the display device 900 may display a screen for the surgeon S to confirm the use consent. If the surgeon S permits the use of the additional functions, step S105 may be executed. If the surgeon S does not permit the use of the additional functions, only the basic functions may be used.

[0544] After obtaining identification code A in step S105, processor 561 applies identification code A to hash function h(x) to calculate hash value h(A). Using a non-reversible transformation function as the hash function protects information unique to the hospital even when it is used as identification code A. Processor 561 refers to hash value Xh stored in memory 562 to determine whether hash value Xh is identical to hash value h(A). If two or more hash values ​​Xh are stored in memory 562, processor 561 performs this determination on each hash value Xh (step S110).

[0545] When the add function is used, the hash value Xh is recorded in memory 562 in step S120, described later. Processor 561 executes step S110 to determine whether the hash value Xh previously recorded in memory 562 is the same as hash value h(A). If hash value Xh and hash value h(A) are the same, processor 561 can determine that the case being processed is the same as the previous case. In this case, the information required for billing is already recorded in memory 562. Therefore, processor 561 does not need to record the information required for billing again in memory 562. On the other hand, if hash value Xh and hash value h(A) are different, processor 561 can determine that the case being processed is different from the previous case. In this case, the information required for billing is not recorded in memory 562. Therefore, when the add function is used, processor 561 records the information required for billing in memory 562 in step S120, described later.

[0546] In step S110, if one hash value Xh is the same as the hash value h(A), Figure 52 The processing shown ends. In step S110, if all hash values ​​Xh are different from the hash value h(A), step S115 is executed.

[0547] In step S110, if all hash values ​​Xh differ from hash value h(A), processor 561 detects the bending pattern of bending portion 112 based on the status information received from drive controller 260B. Based on the detected bending pattern, processor 561 determines whether the additional function is being used (step S115).

[0548] If the additional function is used in step S115, step S120 is executed. If the additional function is not used in step S115, step S125 is executed.

[0549] If the add function is used in step S115, processor 561 increments the usage count N by 1. Furthermore, processor 561 processes the hash value h(A) of identification code A as a new hash value Xh. Processor 561 associates the usage count N and hash value Xh with each other and stores the combination [N, Xh] of the usage count N and hash value Xh in memory 562 (step S120).

[0550] The number of times used N is usage status information, indicating the number of times the additional function has been used. The initial value of the number of times used N is 0. The hash value Xh is the case identification code corresponding to the identification code A. The processor 561 obtains the case identification code by calculating the hash value Xh corresponding to the identification code A (ID) output from the hospital server SV2. The case identification code is not limited to the hash value. The hash value Xh corresponding to the identification code A is different from all the hash values ​​Xh recorded in the memory 562 when executing step S110. The processor 561 records the combination [N, Xh] containing a new case identification code different from the case identification code recorded in the memory 562 in the memory 562. The combination [N, Xh] indicates that the additional function has been used for the case corresponding to the identification code A. The combination [N, Xh] functions as billing information. When the combination [N, Xh] is recorded in the memory 562 in step S120, Figure 52 The indicated processing ends.

[0551] If the add function is not used in step S115 , the processor 561 determines whether the observation or treatment for one case is completed (step S125 ).

[0552] When the observation or treatment of a case is completed in step S125, Figure 52 If the observation or treatment for one case is not completed in step S125, step S115 is executed.

[0553] If the additional function is not used at all during the observation or treatment of a case, step S120 is not executed. Figure 52 The indicated processing ends.

[0554] When the additional function is used for the first time for one case, the processor 561 records the combination [N, Xh] in the memory 562 in step S120. When the additional function is used for one case twice or more, the combination [N, Xh] is not updated.

[0555] For example, after using the additional function for a case, the surgeon S may turn off the power of the electric endoscope system 1000B and then turn on the power of the electric endoscope system 1000B again. After the power is turned on, the processor 561 executes the Figure 52 If the case remains unchanged while the power state is changing, processor 561 determines in step S110 that the hash value Xh is the same as hash value h(A). In this case, the combination [N, Xh] is not updated, and the number of times the additional function is used does not increase. Processor 561 can generate usage status information for each case.

[0556] When a combination [N, Xh] associated with a case identification code is generated, the processor 561 records the generated combination [N, Xh] in the memory 562. If the combination [N, Xh] associated with the case identification code is already recorded in the memory 562, the processor 561 does not generate a new combination [N, Xh] associated with the case identification code. If the use of the additional function is detected and the combination [N, Xh] associated with the case identification code is not recorded in the memory 562, the processor 561 generates a new combination [N, Xh] associated with the case identification code.

[0557] The processor 561 may also detect a state where only basic functions are used. If this state is detected and the combination [N, Xh] associated with the case identification code is recorded in the memory 562, the processor 561 does not need to generate a new combination [N, Xh] associated with the case identification code.

[0558] exist Figure 52 In the example shown, when the contract type is a comprehensive contract or a long-term contract, the usage count N is not recorded in the memory 562. In order to inform the provider of the electric endoscope system 1000B of the usage status of the additional functions in the comprehensive contract or the long-term contract, the usage count of the additional functions in the comprehensive contract or the long-term contract may be recorded in the memory 562. In this case, no billing amount is generated for the use of the additional functions.

[0559] Figure 53 The processing performed when the observation or treatment for a case is completed is shown. Figure 52 After the processing shown is completed, execute Figure 53 The processing shown.

[0560] The processor 561 generates mode usage information indicating whether an additional function is being used. If an additional function is being used, the mode usage information also indicates the type of additional function being used. The processor 561 causes the input / output control unit 564 to communicate with the hospital server SV2, transmitting the image data acquired from the endoscope 100 and the mode usage information to the hospital server SV2 (step S200). The processor 561 may also cause the input / output control unit 564 to transmit the mode usage information along with an observation or diagnosis report to the hospital server SV2.

[0561] The hospital server SV2 receives the image data and mode usage information from the input / output control unit 564. For example, the hospital server SV2 displays the mode usage information on a display device (not shown). People involved in the hospital can check the usage status of the additional function.

[0562] After transmitting the image data and mode usage information in step S200, processor 561 generates usage status information based on the combination [N, Xh] stored in memory 562. The usage status information indicates the use of the additional function. The usage status information may also indicate the number of uses, N. Processor 561 causes input / output control unit 564 to communicate with billing server SV1, transmitting system maintenance information and usage status information to billing server SV1 (step S205).

[0563] When the number of times used N is 0, the processor 561 does not need to transmit the usage status information to the billing server SV1. When the number of times used N is 0, the processor 561 may transmit the usage status information indicating that the additional function is not used to the billing server SV1.

[0564] The billing server SV1 receives system maintenance information and usage information from the input / output control unit 564. Based on the usage information, the billing server SV1 performs billing processing. For example, if the contract type is a pay-as-you-go contract, the billing server SV1 calculates the billing amount based on the usage of the additional function. If the additional function is used for M cases (M is an integer greater than or equal to 1), the billing server SV1 calculates the billing amount corresponding to the M times the additional function is used.

[0565] The processor 561 may not transmit (output) billing information to the billing server SV1 (external server) while the observation or treatment of the case corresponding to the case identification code continues. Alternatively, the processor 561 may transmit (output) billing information to the billing server SV1 when the observation or treatment of the case corresponding to the case identification code is completed.

[0566] In a system where a maintenance operator obtains the system log from the memory 562, the processor 561 does not need to execute Figure 53 The processing shown.

[0567] Each time the additional function is used for a case, the processor 561 may increase the number of uses by 1. The processor 561 may generate usage status information indicating the number of uses for each case.

[0568] When the additional function is used, the processor 561 may also calculate the time the additional function is used. The processor 561 may also generate usage status information indicating this time. For example, the processor 561 calculates the cumulative time that the additional function is used during the observation or treatment of the case corresponding to the case identification code. The cumulative time is the sum of the times that the additional function is used during the observation or treatment of a case. For example, when the additional function is used during the first and second periods, which are different from each other, the processor 561 calculates the cumulative time by summing the length of the first period and the length of the second period. The processor 561 outputs information related to the cumulative time together with the usage status information.

[0569] The mode in which the additional function is used is not limited to the mode related to bending control. The mode in which the additional function is used may also be a diagnosis mode using artificial intelligence (AI). The mode in which the additional function is used may also be a navigation mode.

[0570] In the above example, the processor 561 generates information indicating the use of the additional function for each case. The processor 561 may generate information indicating the use of the additional function regardless of the case.

[0571] In the above example, the processor 561 executes Figure 52 and Figure 53 The drive controller 260B of the drive device 200B included in the control device 600B may also execute Figure 52 and Figure 53 The processing shown.

[0572] The processor 561 or the drive controller 260B can also read in a program and execute the read-in program. The program can also be provided by a "computer-readable recording medium" such as a flash memory. The program can also be transmitted to the control device 600B from the computer storing the program via a transmission medium or by a transmission wave in the transmission medium. The "transmission medium" that transmits the program is a medium with the function of transmitting information. The medium with the function of transmitting information includes networks (communication networks) such as the Internet and communication lines (communication lines) such as telephone lines. The above-mentioned program can also realize part of the above-mentioned functions. In addition, the above-mentioned program can also be a differential file (differential program). The above-mentioned functions can also be realized by a combination of a program already recorded in a computer and a differential program.

[0573] In the electric endoscope system 1000B of the sixth embodiment, hospitals can use additional functions when difficult surgical procedures are required, thereby reducing the cost of introducing the electric endoscope system 1000B. For example, the cost can be made equivalent to the cost of introducing a conventional endoscope system.

[0574] By using the add-on function, hospitals can shorten time-consuming surgical procedures. For example, hospitals can use the add-on function on days with high caseloads. This allows hospitals to flexibly respond to fluctuations in caseloads and improves their operational efficiency.

[0575] Even if you use the additional function more than twice for the observation or treatment of a case, the billing amount will not increase according to the number of times used. Figure 52 In the process shown, a predetermined identification code is obtained. Figure 52 The identification code is used in the process shown, but after the process is completed, the memory 562 does not need to store the identification code. The electric endoscope system 1000B does not need to store a list of various IDs provided by the hospital, thus protecting personal information. By combining the identification code provided by the hospital with the endoscope ID, etc., it is possible to accurately detect the use of additional functions.

[0576] Furthermore, in the present embodiment, the usage status information stored in the past may be used to present useful information to the operator S who operates the electric endoscope system 1000B.

[0577] The surgeon S needs to select a function to be used as needed from among the multiple functions of the electric endoscope system 1000B.

[0578] For example, in addition to the "first bending section control mode (distal end bending section control mode) M1" and the "second bending section control mode (proximal end bending section control mode) M2," the multiple functions also include a "coordinated control mode M3" for controlling the first bending section 113 and the second bending section 114 in a coordinated manner. The bending modes in the coordinated control mode M3 are classified into a "simulated single bending control mode M4 (first mode)" in which the bending section 112 bends as a single bending section, a "coordinated bending control mode M5 (second mode)" in which the first bending section 113 and the second bending section 114 bend in a coordinated manner, and a "simulated single bending transition mode M6 (third mode)."

[0579] Hospital server SV2 stores patient information (electronic medical records) for multiple patients. In addition to the case identification code generated by processor 561, the patient information also includes biological information and case information. The patient information includes biological information such as the patient's age, gender, height, weight, body type, blood pressure, and past surgical history. The patient information also includes case information such as the classification of the lesion, the location of the lesion, and the size of the lesion.

[0580] The hospital server SV2 stores usage information in association with the case identification code included in the patient information. This usage information includes not only billing information used for billing purposes, but also identification information of the surgeon S responsible for the case, the type of surgical procedure (medical procedure) performed in the case, the type of bending mode used in the procedure, and information indicating the time the bending mode was used.

[0581] Identification information of the surgeon S related to the case and the type of surgical procedure (medical action) performed in the case are input to the input / output control unit 564 as usage status information from an input device (eg, a keyboard) not shown.

[0582] Surgeon S operates switch 340 to select a bending mode. Switch 340 allows surgeon S to clearly select the bending mode for the endoscope without releasing his hand from operating device 300. A message confirming whether to use the newly selected bending mode is displayed on display device 900. Surgeon S enters consent by using various buttons 352, etc. The bending mode for the endoscope is thus switched to the newly selected one by operating switch 340. This two-stage selection of the bending mode prevents misuse and incorrect billing.

[0583] The drive controller 260B included in the drive device 200B detects the state of the selector switch 340B and transmits status information indicating the state (information on the bending mode) to the processor 561 of the image control device 500 included in the control device 600B. The processor 561 receives the status information from the drive controller 260B and, based on the status information, detects the bending mode of the bending portion 112 and controls the bending. The processor 561 generates usage status information indicating the bending mode being used.

[0584] Processor 561 is communicatively connected to hospital server SV2, and thus transmits the case identification code and usage status information to hospital server SV2 in association with each other. Hospital server SV2 receives the case identification code and usage status information from input / output control unit 564, and stores them in association with stored patient information.

[0585] When the operator S views the stored usage status information, the operator S inputs the case identification code of the case that the operator S wishes to view to the input / output control unit 564 from an input device (not shown).

[0586] The hospital server SV2 receives the case identification code input to the input / output control unit 564. Based on the case identification code, the hospital server SV2 identifies usage information from the plurality of stored patient information. Specifically, the hospital server SV2 identifies usage information associated with the same case identification code as the one input to the input / output control unit 564. The hospital server SV2 transmits the identified usage information to the input / output control unit 564.

[0587] The display device 900 displays the usage status information received by the input / output control unit 564 .

[0588] In this embodiment, it is possible to provide the surgeon S with useful information that allows the surgeon S to review the surgical operation he or she performed.

[0589] Furthermore, the type of bending mode used in a case can be stored in association with the time it was used, providing useful information indicating when each bending mode was used and for how long. This allows the surgeon S to review the surgical procedure, further improving surgical performance. Furthermore, this information is not only useful for reviewing surgical procedures but also for investigating potential incidents.

[0590] Normally, nurses and other staff members record the surgical process and the drugs used during surgery. In this embodiment, information indicating the use of bending modes used by the surgeon S without the cooperation of staff members can be automatically stored, thereby reducing the recording efforts of nurses and staff members.

[0591] As described above, effective use of the usage status information generated by the electric endoscope system can contribute to efficient surgical procedures, improved performance, and cost reduction.

[0592] (Seventh embodiment)

[0593] The electric endoscope system of the seventh embodiment of the present invention has a function of displaying a three-dimensional image of the bending portion 112. The three-dimensional image is a computer graphic (CG) representing the shape of the bending portion 112. In order to display the three-dimensional image, it is necessary to determine the direction of the line of sight of the surgeon S. The direction of the line of sight of the surgeon S is the direction from the viewpoint toward the endoscope 100. It is desirable to determine the direction of the line of sight in such a way that the surgeon S can easily grasp the bending direction. In the case of using the coordinated bending control mode M5, etc., it may be difficult for the surgeon S to grasp the bending direction through the display method of the three-dimensional image. Therefore, it is necessary to determine the direction of the line of sight of the surgeon S and appropriately display the three-dimensional image.

[0594] The seventh embodiment provides an electric endoscope system (surgery support system) that displays a three-dimensional image for allowing a surgeon S to easily understand the bending direction.

[0595] Reference Figure 54 In the following description, the same reference numerals are assigned to the same components as those already described, and duplicate descriptions are omitted.

[0596] like Figure 54 As shown, the electric endoscope system 1000G is a medical system for observing and treating the body of a patient P lying on an operating table T. The electric endoscope system 1000G includes an endoscope 100, a driving device 200B, an operating device 300B, a treatment instrument 400, and an image control device 500 (see FIG. Figure 1 ), camera 570, and display device 900 (monitor).

[0597] Camera 570 is installed in the operating room. Camera 570 is an imaging device having an image sensor (such as a CCD sensor or a CMOS sensor). Camera 570 generates an image that includes the imaging field of view of the surgeon S, the endoscope 100, and the display device 900. Camera 570 is connected to the input / output control unit 564 of the image control device 500. Camera 570 transmits the generated image to the input / output control unit 564. Two or more cameras may also be installed.

[0598] The input / output control unit 564 communicates with the camera 570 to receive images. The processor 561 of the image control device 500 obtains the images received by the input / output control unit 564 from the input / output control unit 564. The processor 561 processes the images and detects a first direction and a second direction. The first direction is a direction relative to the endoscope 100 (insertion portion 110). The second direction is a direction relative to the display device 900. The first direction and the second direction are both straight line directions. Based on the first and second directions, the processor 561 determines the direction of the line of sight used to display the three-dimensional image representing the shape of the bending portion 112.

[0599] The drive controller 260B of the drive device 200B communicates with the input / output control unit 564, transmitting the bending amount of the first bending portion 113 in the UD direction, the bending amount of the first bending portion 113 in the LR direction, the bending amount of the second bending portion 114 in the UD direction, and the bending amount of the second bending portion 114 in the LR direction. The input / output control unit 564 receives each bending amount and outputs it to the processor 561. Based on each bending amount, the processor 561 generates a three-dimensional image (three-dimensional model) of the endoscope 100 observed in the determined direction. The processor 561 displays the three-dimensional image on the display device 900.

[0600] Reference Figure 55 , the processing for displaying a three-dimensional image is described. Figure 55 5 is a flowchart showing the steps of the process performed by the processor 561.

[0601] The processor 561 causes the input / output control unit 564 to communicate with the camera 570, and receives an image from the camera 570. The processor 561 obtains the image received by the input / output control unit 564 from the input / output control unit 564 (step S300).

[0602] After acquiring the image in step S300, the processor 561 processes the image and detects the first direction and the second direction (step S305). Specifically, the processor 561 detects the first direction by detecting the tilt of the endoscope 100 using object detection or three-dimensional measurement methods. Furthermore, the processor 561 detects the second direction by detecting the orientation of the display device 900.

[0603] Figure 56 and Figure 57 1 is a diagram showing the positional relationship between the endoscope 100 and the display device 900 .

[0604] exist Figure 56 and Figure 57In FIG, a first direction DR1 and a second direction DR2 are shown. For example, the first direction DR1 is the direction in which the endoscope 100 is inserted into the lumen of the patient P. For example, the second direction DR2 is related to the direction of the line of sight of the surgeon S. Figure 56 and Figure 57 In the example shown, the second direction DR2 is a direction parallel to the horizontal plane and perpendicular to the screen of the display device 900 .

[0605] exist Figure 56 In the example shown, the second direction DR2 is approximately parallel to the first direction DR1. Figure 57 In the example shown, the second direction DR2 is close to a direction perpendicular to the first direction DR1 .

[0606] The processor 561 does not need to accurately detect the first direction and the second direction. The processor 561 can distinguish Figure 56 The status shown and Figure 57 The first direction and the second direction are detected with the accuracy of the state shown.

[0607] After detecting the first direction and the second direction in step S305 , the processor 561 determines the direction of the line of sight for displaying the three-dimensional image based on the first direction and the second direction (step S310 ).

[0608] For example, the viewpoint for displaying a three-dimensional image is set to a position where at least the distal end portion 111 and the curved portion 112 are included in the field of view. Figure 56 In the example shown, the second direction DR2 is close to the direction parallel to the insertion direction of the endoscope 100, so the processor 561 sets the direction of the line of sight to the direction from the internal soft part 119 side toward the front end part 111 side (the longitudinal direction A of the endoscope 100). Figure 57 In the example shown, the second direction DR2 is close to a direction perpendicular to the insertion direction of the endoscope 100 , and therefore the processor 561 sets the direction of the line of sight to a direction intersecting the longitudinal direction A of the endoscope 100 .

[0609] The processor 561 determines the direction of the endoscope 100 in the three-dimensional image based on the angle (relative angle) between the first direction DR1 and the second direction DR2. Figure 56 In the example shown, the first direction DR1 and the second direction DR2 are the same, and the relative angle is 0. Therefore, the processor 561 sets the direction of the endoscope 100 in the three-dimensional image to be the same as the reference direction. The reference direction is defined as the direction of the endoscope 100 in the three-dimensional image displayed when the relative angle is 0.

[0610] exist Figure 57In the example shown, the first direction DR1 and the second direction DR2 are almost perpendicular, and the relative angle is about 90 degrees. Therefore, the processor 561 changes the direction of the endoscope 100 in the three-dimensional image from the reference direction. Figure 57 In the example shown, the processor 561 rotates the orientation of the endoscope 100 in the three-dimensional image by 90 degrees.

[0611] exist Figure 56 and Figure 57 In the example shown, it is assumed that the operator S is facing the display device 900. Therefore, the position of the operator S is included in the direction of the display device 900, and the processor 561 does not need to detect the position of the operator S.

[0612] After determining the direction of the line of sight in step S310 , the processor 561 causes the input / output control unit 564 to communicate with the drive controller 260B, and obtains the bending amounts of the first bending portion 113 and the second bending portion 114 from the input / output control unit 564 (step S315 ).

[0613] After obtaining the bending amounts of the first bending portion 113 and the second bending portion 114 in step S315, the processor 561 generates a three-dimensional image of the endoscope 100 viewed in the direction determined in step S310 based on the bending amounts. At this time, the processor 561 determines the direction of the endoscope 100 in the three-dimensional image (step S320).

[0614] After generating the three-dimensional image in step S320, the processor 561 outputs the three-dimensional image to the display device 900 via the input / output control unit 564. The display device 900 displays the three-dimensional image (step S325).

[0615] Figure 58 and Figure 59 An example of a three-dimensional image displayed by the display device 900 is shown. Figure 58 In the example shown, a three-dimensional image IMG1 is displayed on a screen 902 of a display device 900. Figure 59 In the example shown, a three-dimensional image IMG2 is displayed on a screen 902 of a display device 900. The three-dimensional images IMG1 and IMG2 show the state of the bending portion 112 viewed in a direction close to the line of sight of the surgeon S. Therefore, the surgeon S can easily grasp the bending direction.

[0616] The processor 561 can also be used in conjunction with Figure 55Step S315 is executed at a different timing than shown to obtain the bending amounts of the first bending portion 113 and the second bending portion 114. For example, the processor 561 may execute step S315 before executing any one of steps S300, S305, and S310.

[0617] The drive controller 260B of the drive device 200B may also communicate with the input / output control unit 564 to transmit the rotation angle of the cylindrical member 121. The input / output control unit 564 may also receive the rotation angle and output it to the processor 561. The processor 561 may also generate a three-dimensional image of the endoscope 100 based on the respective bending amounts and the rotation angle.

[0618] In the above example, the processor 561 executes Figure 55 The process shown in FIG. can also be executed by the drive controller 260B of the drive device 200B Figure 55 The processor 561 or the drive controller 260B may also read a program and execute the read program.

[0619] In the above example, a single display device is provided, but two display devices may also be provided. For example, one display device may display images acquired by the endoscope, while the other may display a three-dimensional image. In this case, it is desirable to determine the direction of the surgeon's line of sight based on the display device displaying the three-dimensional image.

[0620] In the above example, the first direction and the second direction are detected by the camera 570 , but the direction of the line of sight may be manually set without using a camera.

[0621] Another method for the processor 561 to determine the direction of the line of sight in step S310 is described. In the following method, the second direction is related to the direction of the line of sight of the surgeon S and varies depending on the positional relationship between the display device 900 and the surgeon S.

[0622] One or more cameras 570 are placed at positions where the operator S, the endoscope 100, and the display device 900 can be captured within the field of view. Alternatively, one or more cameras 570 are placed on the display device 900 and fixed at positions where the operator S and the endoscope 100 can be captured within the field of view.

[0623] The processor 561 detects the first direction corresponding to the tilt of the endoscope 100 using the same method as described above. The processor 561 also detects the direction from the operator S toward the display device 900 as the second direction using object detection or three-dimensional measurement techniques.

[0624] Figure 60、 Figure 61 as well as Figure 62 1 is a diagram showing the positional relationship among the operator S, the endoscope 100 , and the display device 900 .

[0625] exist Figure 60 、 Figure 61 as well as Figure 62 , a first direction DR1 and a second direction DR2 are shown. For example, the first direction DR1 is the direction in which the endoscope 100 is inserted into the lumen of the patient P. For example, the second direction DR2 is related to a direction determined based on the position of the display device 900 and the position of the surgeon S. In other words, the second direction DR2 is related to the direction of the surgeon S's line of sight. Figure 60 、 Figure 61 as well as Figure 62 In the example shown, the second direction DR2 is a direction from the position of the operator S toward the position of the display device 900. For example, the position of the operator S is the viewpoint of the operator S. For example, the position of the display device 900 is the center position of the screen of the display device 900.

[0626] exist Figure 60 In the example shown, the second direction DR2 is approximately parallel to the first direction DR1. Figure 61 and Figure 62 In the examples shown respectively, the second direction DR2 is different from the first direction DR1 .

[0627] Figure 63 、 Figure 64 as well as Figure 65 : is a diagram showing the relationship between the first direction DR1 and the second direction DR2. Figure 63 In the example shown, the first direction DR1 is identical to the second direction DR2 . Figure 65 The angle ANG2 shown is greater than Figure 64 The angle ANG1 shown is large. Angles ANG1 and ANG2 represent the angles (relative angles) between the first direction DR1 and the second direction DR2. The processor 561 determines the direction of the line of sight so that the angle between the longitudinal direction A (long axis direction) of the endoscope 100 in the three-dimensional image and the direction of the line of sight used to display the three-dimensional image is the same as the angle between the first direction DR1 and the second direction DR2.

[0628] exist Figure 63 、 Figure 64 as well as Figure 65 In FIG, the longitudinal direction A of the endoscope 100 is the same as the first direction DR1 and the reference direction for displaying a three-dimensional image. The processor 561 determines the direction of the endoscope 100 in the three-dimensional image based on the relative angle between the first direction DR1 and the second direction DR2. Figure 63In the example shown, the first direction DR1 and the second direction DR2 are the same, and the relative angle is 0. Therefore, the processor 561 sets the direction of the endoscope 100 in the three-dimensional image to be the same as the reference direction. The reference direction is defined as the direction of the endoscope 100 in the three-dimensional image displayed when the relative angle is 0.

[0629] exist Figure 64 and Figure 65 In the example shown, the first direction DR1 and the second direction DR2 are different, and the relative angle is larger than 0. Therefore, the processor 561 changes the direction of the endoscope 100 in the three-dimensional image from the reference direction. Figure 64 In the example shown, the processor 561 rotates the direction of the endoscope 100 in the three-dimensional image by an angle ANG1. Figure 65 In the example shown, the processor 561 rotates the orientation of the endoscope 100 in the three-dimensional image by an angle ANG2.

[0630] The processor 561 may also process the image generated by the camera 570 to obtain the position of the display device 900 and the position of the surgeon S. The processor 561 may also determine the second direction DR2 based on the position of the display device 900 and the position of the surgeon S. Specifically, the second direction DR2 is the direction from the position of the surgeon S toward the position of the display device 900.

[0631] Figure 60 The image IMG11 shown, Figure 61 The image IMG12 shown and Figure 62 The image IMG13 shown shows an example of a three-dimensional image displayed on the display device 900. The direction from the operator S toward the display device 900 varies depending on the positional relationship between the display device 900 and the operator S. Therefore, the direction of the endoscope 100 in the three-dimensional image displayed on the display device 900 varies.

[0632] As described above, the processor 561 generates a three-dimensional model representing the curved shape of the insertion portion 110 and displays the generated three-dimensional model on the display device 900. The processor 561 obtains first information (first direction DR1) related to a first straight line indicating the insertion direction of the insertion portion 110 and obtains second information (second direction DR2) related to a second straight line indicating the operator's line of sight. Based on the first and second information, the processor 561 determines the orientation of the three-dimensional model displayed on the display device 900.

[0633] The processor 561 calculates the relative angle between the second straight line and the first straight line. The processor 561 changes the direction of the three-dimensional model from the reference direction based on the calculated relative angle.

[0634] The processor 561 obtains the first information and the second information from an image generated by a camera 570 provided in the operating room.

[0635] The processor 561 also obtains from the image first position information regarding the position of the display device 900 and second position information regarding the position of the surgeon S (operator). The processor 561 obtains the second information based on the first position information and the second position information.

[0636] The processor 561 may display the current value of the bending amount and the maximum value (limit value) of the bending amount on the display device 900. For example, the processor 561 generates an image (CG) for displaying the current value and the maximum value, and displays the image on the display device 900.

[0637] Figures 66 to 72 : is a diagram showing an example of an image for displaying a current value and a maximum value.

[0638] Figure 66 The first example is shown. Measuring instruments MT1, MT2, MT3, and MT4 are displayed on the display device 900. Each measuring instrument is circular. Measuring instrument MT1 displays the bending amount of the first curved portion 113 in the UD direction. The angle of needle ND1 of measuring instrument MT1 indicates the current value of the bending amount. Measuring instrument MT2 displays the bending amount of the first curved portion 113 in the LR direction. The angle of needle ND2 of measuring instrument MT2 indicates the current value of the bending amount. Measuring instrument MT3 displays the bending amount of the second curved portion 114 in the UD direction. The angle of needle ND3 of measuring instrument MT3 indicates the current value of the bending amount. Measuring instrument MT4 displays the bending amount of the second curved portion 114 in the LR direction. The angle of needle ND4 of measuring instrument MT4 indicates the current value of the bending amount. The end of the range displayed by needle ND1 or needle ND3 indicates the maximum bending amount in the UD direction. The end of the range displayed by needle ND2 or needle ND4 indicates the maximum bending amount in the LR direction.

[0639] Figure 67A second example is shown. Measuring instruments MT5 and MT6 are displayed on the display device 900. Measuring instruments MT5 and MT6 are circular. Measuring instrument MT5 includes display bars BR1 and BR2. Display bar BR1 shows the curvature of the first curved portion 113 in the UD direction. Angle AG1 of display bar BR1 indicates the current curvature value. Display bar BR2 shows the curvature of the first curved portion 113 in the LR direction. Angle AG2 of display bar BR2 indicates the current curvature value. Measuring instrument MT6 includes display bars BR3 and BR4. Display bar BR3 shows the curvature of the second curved portion 114 in the UD direction. Angle AG3 of display bar BR3 indicates the current curvature value. Display bar BR4 shows the curvature of the second curved portion 114 in the LR direction. Angle AG4 of display bar BR4 indicates the current curvature value. The end of the range displayed by display bar BR1 or display bar BR3 indicates the maximum curvature value in the UD direction. The end of the range displayed by display bar BR2 or display bar BR4 indicates the maximum curvature value in the LR direction.

[0640] exist Figure 66 or Figure 67 In the example shown, the current value of the bending amount and the maximum value of the bending amount are displayed as angles. Therefore, the surgeon S can easily understand the current value of the bending amount and the maximum value of the bending amount. Figure 67 In the example shown, the bending amount in the UD direction and the bending amount in the LR direction are displayed by one measuring instrument. Figure 66 Compared with the example shown, the screen area required for display is saved.

[0641] Figure 68 A third example is shown. Data bar DB1, data bar DB2, data bar DB3, and data bar DB4 are displayed on the display device 900. Each data bar is in the shape of a bar. Data bar DB1 shows the bending amount of the first curved portion 113 in the UD direction. Data bar DB2 shows the bending amount of the first curved portion 113 in the LR direction. Data bar DB3 shows the bending amount of the second curved portion 114 in the UD direction. Data bar DB4 shows the bending amount of the second curved portion 114 in the LR direction. The end of the range displayed by data bar DB1 or data bar DB3 indicates the maximum bending amount in the UD direction. The end of the range displayed by data bar DB2 or data bar DB4 indicates the maximum bending amount in the LR direction.

[0642] The first curved portion 113 and the second curved portion 114 are curved in the UD direction based on the rotation operation of the first angle knob 320. Therefore, the data strips DB1 and DB3 are associated with the rotation operation of the first angle knob 320. The first curved portion 113 and the second curved portion 114 are curved in the LR direction based on the rotation operation of the second angle knob 330. Therefore, the data strips DB2 and DB4 are associated with the rotation operation of the second angle knob 330. The data strips DB1 and DB2 are arranged in the left-right direction in the image. Similarly, the data strips DB3 and DB4 are arranged in the left-right direction in the image. The length of the area displaying each data strip in the up-down direction is longer than the length of the area in the left-right direction. Each data strip extends in the up-down direction in the image.

[0643] When the first angle knob 320 is rotated, the outer portion of the first angle knob 320, which is separated from the rotation axis 300r, rotates toward the upper UPR or the lower LWR. The upper UPR is associated with the upper direction in the image, and the lower LWR is associated with the lower direction in the image. Therefore, the surgeon S can easily and intuitively grasp the rotation direction of the first angle knob 320 and the direction in which the data bars DB1 and DB3 extend. In other words, the surgeon S can easily and intuitively grasp the rotation direction of the first angle knob 320 and the bending amount in the UD direction of each of the first and second bending portions 113 and 114.

[0644] Similarly, when the second angle knob 330 is rotated, the outer portion of the second angle knob 330, separated from the rotation axis 300r, rotates toward the upper UPR or lower LWR. The upper UPR is associated with the upper direction in the image, and the lower LWR is associated with the lower direction in the image. Therefore, the surgeon S can easily and intuitively grasp the rotation direction of the second angle knob 330 and the direction in which the data bars DB2 and DB4 extend. In other words, the surgeon S can easily and intuitively grasp the rotation direction of the second angle knob 330 and the bending amount of the first bending portion 113 and the second bending portion 114 in the LR direction.

[0645] Figure 72A fourth example is shown. Data bars DB5, DB6, DB7, and DB8 are displayed on the display device 900. Each data bar is in the shape of a bar. Data bar DB5 shows the bending amount of the first curved portion 113 in the UD direction. Data bar DB6 shows the bending amount of the first curved portion 113 in the LR direction. Data bar DB7 shows the bending amount of the second curved portion 114 in the UD direction. Data bar DB8 shows the bending amount of the second curved portion 114 in the LR direction. The end of the range displayed by data bar DB5 or DB7 indicates the maximum bending amount in the UD direction. The end of the range displayed by data bar DB6 or DB8 indicates the maximum bending amount in the LR direction.

[0646] exist Figure 68 or Figure 72 In the example shown, the surgeon S can easily understand how to observe each data bar, saving the area of ​​the screen required for display. Figure 72 In the example shown, the amount of curvature in the UD direction is displayed by a data bar extending in the up-down direction, and the amount of curvature in the LR direction is displayed by a data bar extending in the left-right direction. Figure 68 Compared with the example shown, the surgeon S can more easily grasp the bending state intuitively.

[0647] When displaying the three-dimensional image of the bending portion 112, the electric endoscope system 1000G (processor 561) may also emphasize the image corresponding to the bent portion based on an operation by the surgeon S. In other words, the electric endoscope system 1000G (processor 561) may emphasize the image of the bent portion associated with the bending mode.

[0648] For example, when the bending mode is the "first bending portion control mode (front end side bending portion control mode) M1", the first bending portion 113 is bent. Therefore, for example, the processor 561 Figure 69 The image IMG21 is displayed on the display device 900. At this time, the processor 561 emphasizes the first bending portion 113 by changing its color to a color different from that of other parts of the insertion portion 110 (the distal end portion 111, the second bending portion 114, and the internal soft portion 119).

[0649] When the bending mode is the "second bending portion control mode (proximal side bending portion control mode) M2", the second bending portion 114 bends. Therefore, for example, the processor 561 Figure 70 The image IMG22 is displayed on the display device 900. At this time, the processor 561 emphasizes the second bending portion 114 by changing its color to a color different from that of other parts of the insertion portion 110 (the distal end portion 111, the first bending portion 113, and the internal soft portion 119).

[0650] When the bending mode is the "coordinated control mode M3", the first bending portion 113 and the second bending portion 114 are bent. Therefore, for example, the processor 561 Figure 71 The image IMG23 is displayed on the display device 900. At this time, the processor 561 changes the color of the first and second curved portions 113 and 114 to a color different from that of other parts of the insertion portion 110 (the distal end portion 111 and the internal soft portion 119) to emphasize the first and second curved portions 113 and 114.

[0651] The electric endoscope system 1000G of the seventh embodiment displays a three-dimensional image showing the state of the bending portion 112 viewed in a direction close to the line of sight of the operator S on the display device 900. Therefore, the operator S can easily grasp the bending direction.

[0652] The electric endoscope system 1000G displays the current value of the bending amount and the maximum value of the bending amount on the display device 900. Therefore, the operator S can grasp the current value of the bending amount and the maximum value of the bending amount.

[0653] The electric endoscope system 1000G emphasizes the image of the bending portion associated with the bending mode. Therefore, even if the electric endoscope system 1000G has multiple bending portions and multiple bending modes, the surgeon S can understand the relationship between the operation of the operating device 300 and the bending portion bent based on the operation while directly observing the display device 900.

[0654] (Eighth Embodiment)

[0655] Reference Figures 73 to 75 Next, an electric endoscope system 1000H according to an eighth embodiment of the present invention will be described. In the following description, the same reference numerals are assigned to the same components as those already described, and duplicate descriptions will be omitted. Figure 73 It is an overall view of the electric endoscope system 1000H according to this embodiment. Figure 74 This is a top view of the electric endoscope system 1000H.

[0656] [Electric Endoscope System 1000H]

[0657] like Figure 73 As shown, an electric endoscope system 1000H is a medical system for observing and treating the body of a patient P lying on an operating table T. The electric endoscope system 1000H includes an endoscope 100H, a drive device 200, an operating device 300, a treatment instrument 400, an image control device 500, a support device 700, an observation device 800, and a display device 900.

[0658] [Endoscope 100H]

[0659] like Figure 73 As shown, the endoscope 100H includes an insertion portion 110H, a connection portion 120, an external flexible portion 140, a detachable portion 150H, a bending wire 160, and an internal component 170. The insertion portion 110H, the connection portion 120, the external flexible portion 140, and the detachable portion 150H are connected in order from the distal end side.

[0660] [Insertion section 110H]

[0661] The insertion portion 110H differs from the insertion portion 110 of the first embodiment only in that a magnetic coil (not shown) is built in along the longitudinal direction A. The magnetic coil is, for example, spirally mounted along the inner circumferential surface of the internal path 101 of the insertion portion 110H.

[0662] [Loading and unloading section 150H]

[0663] like Figure 73 As shown, the attachment / detachment unit 150H includes a first attachment / detachment unit 1501 attached to the driving device 200 and a second attachment / detachment unit 1502 attached to the image control device 500 , and further includes an attachment / detachment position and posture sensor 1504 .

[0664] The attachment / detachment position and posture sensor 1504 detects the position and posture of the proximal end portion of the attached external flexible portion 140. For example, the attachment / detachment position and posture sensor 1504 detects the position of the proximal end portion of the external flexible portion 140 relative to the control device 600 and the posture of the proximal end portion of the external flexible portion 140. The detection results of the attachment / detachment position and posture sensor 1504 are obtained by the main controller 560.

[0665] [Supporting device 700]

[0666] The support device 700 is a device that movably supports the endoscope 100H and includes a base 710 , an arm 720 , and an endoscope support portion 730 .

[0667] The base 710 is a long member installed on the ground. The base 710 extends to a position higher than the operating table T. The arm 720 is a long member, one end of which is connected to the front end of the base 710. The arm 720 is connected to the base 710 via a two-degree-of-freedom joint, for example, and the other end of the arm 720 is movable in the longitudinal direction A of the endoscope 100H and in the vertical direction (the direction in which the base 710 extends).

[0668] The endoscope support portion 730 includes a support portion main body 731 that supports the external flexible portion 140 of the endoscope 100H and an endoscope position and posture sensor 732. The support portion main body 731 is connected to the other end of the arm 720 so as to be rotatable about the longitudinal axis of the arm 720. The support portion main body 731 has a generally cylindrical shape and is detachably attached to the outer periphery of the external flexible portion 140. In this embodiment, the endoscope support portion 730 is attached near the distal end of the external flexible portion 140.

[0669] The endoscope position and posture sensor 732 is a sensor that detects the position and posture of the supported external flexible portion 140. For example, the endoscope position and posture sensor 732 detects the position near the distal end of the external flexible portion 140 relative to the control device 600, or the posture near the distal end of the external flexible portion 140. The main controller 560 obtains the detection results of the endoscope position and posture sensor 732 via the transmission cable 701. Alternatively, the main controller 560 may obtain the joint values ​​of the arm 720 using an encoder and calculate the position and posture based on these values ​​through kinematic calculations. Alternatively, the main controller 560 may calculate the position and posture using the camera 570.

[0670] Unless a force exceeding a predetermined value is applied, the arm 720 will not move relative to the base 710. Furthermore, unless a force exceeding a predetermined value is applied, the endoscope support 730 will not rotate relative to the arm 720. Therefore, even if the surgeon S removes his right hand R from the internal soft part 119 to operate the treatment instrument 400, the position and posture of the external soft part 140 supported by the support device 700 will not change.

[0671] [Observation device 800]

[0672] The observation device 800 is a device that observes the insertion shape of the endoscope 100H using a magnetic field. The observation device 800 receives magnetic fields generated by a magnetic coil built into the insertion portion 110H of the endoscope 100H via an antenna. Figure 74 As shown, the observation device 800 is configured so that the internal body part inserted into the body through the insertion section 110H enters the receiving range of the observation device 800, and thus can receive magnetism generated from the internal body part inserted into the body through the insertion section 110H.

[0673] Based on the received magnetic field, the observation device 800 estimates the shape (first estimated shape) SS1 of the internal part of the body inserted into the body through the internal path 101 of the insertion portion 110H. The observation device 800 generates the shape SS1 as a three-dimensional graphic image and displays it on the display device 900. Alternatively, the observation device 800 may be a device that observes the shape SS1 of the endoscope 100H using other methods such as X-ray photography. The main controller 560 also obtains the observation results of the observation device 800.

[0674] The resulting shapes of the insertion portion 110H and the external flexible portion 140 are used, for example, to achieve high-precision bending motions. Typically, the ratio of the wire tension Tin at the base end of the flexible portion to the wire tension Tout at the distal end is expressed as Tout / Tin = exp(-μθ), using the sum of the bending angles θ along the flexible portion path and the friction coefficient μ between the wire and sheath. For example, by using the relationship shown below to correct the wire's traction tension and amount, high-precision bending motions can be achieved.

[0675] Next, a method of using the electric endoscope system 1000H of this embodiment will be described. Specifically, a surgical procedure for observing and treating an affected area formed on the tube wall in the large intestine using the electric endoscope system 1000H will be described.

[0676] Later, according to Figure 75 The control flow chart of the main controller 560 of the control device 600 shown in FIG. 1 is used to describe the control flow chart. When the control device 600 is started, the main controller 560 performs initialization and then starts control (step S800). Next, the main controller 560 (mainly the processor 561) executes step S810.

[0677] Surgeon S inserts the insertion portion 110H of the endoscope 100H from the front end through the anus of the patient P into the large intestine. While observing the camera image displayed on the display device 900, surgeon S uses his right hand R to manipulate the internal soft portion 119, moving the insertion portion 110H so that the front end portion 111 approaches the affected area. Surgeon S also uses his left hand L to manipulate the first angle knob 320 and the second angle knob 330 of the operating device 300 to bend the bending portion 112 as needed.

[0678] In step S810, the main controller 560 obtains the shape SS1 of the internal portion of the insertion section 110H inserted into the body from the observation device 800. Furthermore, based on the shape SS1 of the internal portion of the internal pathway 101 inserted into the body and the total length of the internal pathway 101, including the insertion section 110H and the external flexible portion 140, the main controller 560 obtains the length SS2L of the external portion of the internal pathway 101 located outside the body. Next, the main controller 560 executes step S820.

[0679] In step S820, the main controller 560 obtains the position and posture of the proximal end portion of the external soft portion 140 from the attachment and detachment position and posture sensor 1504. Next, the main controller 560 executes step S830.

[0680] In step S830, the main controller 560 obtains the position and posture of the vicinity of the distal end of the external flexible portion 140 from the endoscope position and posture sensor 732. Next, the main controller 560 executes step S840.

[0681] In step S840, the main controller 560 estimates the shape (second estimated shape) SS2 of the external portion of the internal path 101 located outside the body based on the position and posture acquired from the attachment and detachment position and posture sensor 1504 and the endoscope position and posture sensor 732, the length SS2L, and the rigidity of the flexible portion (the insertion portion 110H and the external flexible portion 140). The main controller 560 estimates the position and posture of the remaining portions of the external flexible portion 140 based on the position and posture of the proximal end portion of the external flexible portion 140, the position and posture near the distal end portion of the external flexible portion 140, the length SS2L (i.e., the length of shape SS2), and the rigidity of the flexible portion (the insertion portion 110H and the external flexible portion 140), thereby estimating shape SS2. The main controller 560 then executes step S850.

[0682] In step S850, the main controller 560 generates or updates the path (estimated path) SR of the bending line 160 based on the estimated shape of the in-vivo part of the internal path 101 (first estimated shape, in-vivo shape information) SS1 and the shape of the in-vivo part of the internal path 101 (second estimated shape, in-vivo shape information) SS2.

[0683] The main controller 560 then executes step S860. In step S860, the main controller 560 determines whether to terminate the control. If the control is not terminated, the main controller 560 executes step S810 again. If the control is terminated, the main controller 560 executes step S870 and terminates the control.

[0684] The generated or updated estimated path SR of the bending wire 160 is obtained by the drive controller 260. When the drive controller 260 controls the wire drive unit 250 based on the operation input received from the operating device 300 to operate the bending portion 112, it calculates the transmission efficiency of the bending wire 160 based on the estimated path SR and the actual pulling amount and feeding amount of the bending wire 160. As a result, the drive controller 260 can operate the bending portion 112 more accurately.

[0685] The electric endoscope system 1000H of this embodiment enables more efficient observation or treatment using the endoscope 100H. Since the endoscope 100H and the operating device 300 are separate, the surgeon S can operate the endoscope 100H and the operating device 300 independently without affecting each other.

[0686] As the driving device 200 is separated from the operating device 300, the path of the bending line 160 from the insertion portion 110H of the endoscope 100H to the driving device 200 sometimes becomes longer, but the driving controller 260 can easily make the bending portion 112 bend accurately by calculating the transmission efficiency of the bending line 160 based on the estimated path SR.

[0687] When the external flexible portion 140 is elongated, it is difficult to generate the estimated path SR for the bending line 160 based solely on the observation results of the observation device 800. The electric endoscope system 1000H uses, in addition to the shape SS1 of the internal portion of the internal path 101 observed by the observation device 800, the shape SS2 of the external portion of the internal path 101 estimated based on the position and posture acquired from the attachment and detachment position and posture sensor 1504 and the endoscope position and posture sensor 732. As a result, the electric endoscope system 1000H can generate a more accurate estimated path SR.

[0688] The eighth embodiment of the present invention has been described in detail with reference to the accompanying drawings, but the specific structure is not limited to this embodiment and also includes design changes within the scope of the present invention. In addition, the structural elements shown in the above-mentioned embodiments and modifications can be appropriately combined to form.

[0689] (Variation 8-1)

[0690] In the above embodiment, the endoscope support portion 730 supports the external flexible portion 140 of the endoscope 100H. However, the endoscope support portion 730 is not limited to this embodiment. The endoscope support portion 730 may also support the internal flexible portion 119 of the endoscope 100H to detect the position and posture of the internal flexible portion 119. Furthermore, the endoscope support portion 730 may also support the connecting portion 120 of the endoscope 100H to detect the position and posture of the connecting portion 120.

[0691] Alternatively, the flexible portion length may be appropriately set to be as short as possible to prevent the flexible portion (insertion portion 110H and external flexible portion 140) from becoming coiled outside the body. Based on the relative positional relationship between the endoscope attachment and detachment portion and the anus, the external portion length SS2L, and the rigidity of the flexible portion (insertion portion 110H and external flexible portion 140), the external bending shape can be estimated. The linear tension attenuation can be calculated based on the sum of the bending angles to set the control parameters. The relative position between the endoscope attachment and detachment portion and the anus can also be estimated by taking a picture of a marker located at or near the anus using a camera mounted on the drive device 200.

[0692] (Variation 8-2)

[0693] In the above embodiment, the main controller 560 estimates the shape SS2 of the external portion of the internal path 101 based on the position and posture obtained from the attachment and detachment position and posture sensor 1504 and the endoscope position and posture sensor 732. However, the method for estimating the shape of the external portion of the internal path 101 is not limited to this. The main controller 560 may also estimate the shape SS2 based on the output of only one of the attachment and detachment position and posture sensor 1504 and the endoscope position and posture sensor 732. Furthermore, the main controller 560 may estimate the shape SS2 by considering the length of the external flexible portion 140 in addition to the position obtained from the attachment and detachment position and posture sensor 1504 and the endoscope position and posture sensor 732, thereby enabling a more accurate estimation. Furthermore, the main controller 560 may also estimate the shape SS2 based on the sum of the bending angles of the external flexible portion 140 and the roller rotation amount.

[0694] (Variation 8-3)

[0695] The main controller 560 can also estimate the shape SS2 of the external portion of the internal path 101 based on the image of the external flexible portion 140 and the like obtained from the camera 570. If markers are pre-attached to the distal end and the proximal end of the external flexible portion 140, the main controller 560 can estimate the shape SS2 of the external portion of the internal path 101 with higher accuracy.

[0696] (Ninth embodiment)

[0697] Reference Figures 76 to 81 A ninth embodiment of the present invention is described below with respect to an electric endoscope system 1000I. In the following description, the same reference numerals are given to the same components as those already described, and redundant descriptions are omitted. Figure 76 It is an overall view of the electric endoscope system 1000I according to this embodiment.

[0698] [Electric Endoscope System 1000I]

[0699] like Figure 76 As shown, an electric endoscope system 1000I is a medical system for observing and treating the body of a patient P lying on an operating table T. The electric endoscope system 1000I includes an endoscope 100C, a drive device 200I, an operating device 300, a treatment instrument 400, an image control device 500, and a display device 900. The drive device 200I and the image control device 500 constitute a control device 600I that controls the electric endoscope system 1000I.

[0700] [Drive device 200I]

[0701] Figure 77 This is a functional block diagram of the driving device 200I.

[0702] The driving device 200I includes an adapter 210C, an operation receiving unit 220 , an air supply and suction driving unit 230 , a wire driving unit 250C, and a driving controller 260I.

[0703] The driving device 200I can independently drive a pair of bending wires that bend the bending portion 112 in the UD direction, similarly to the driving device 200C of the third embodiment. In addition, the electric endoscope system 1000I can independently drive a pair of bending wires 160 that bend the bending portion 112 in the LR direction.

[0704] [Drive controller 260I]

[0705] The drive controller 260I controls the entire drive device 200I. The drive controller 260I differs from the drive controller 260C of the third embodiment in its method of controlling the wire drive unit 250C. The drive controller 260I switches the drive mode of the wire drive unit 250C based on the curved shape of the curved portion 112. The drive controller 260I can switch the drive mode of the wire drive unit 250C to either a first drive mode or a second drive mode.

[0706] [Restoration force F1 and friction force F2]

[0707] The curved portion 112 is acted upon by a restoring force F1 which is a force caused by the rubber or the like forming the outer sheath 118 to return the curved portion 112 to a straight state, and a friction force F2 which is a force that overcomes the restoring force F1 and maintains the shape.

[0708] Figure 78 1 is a diagram showing a restoring force F1 acting on the curved portion 112 .

[0709] The restoring force F1 is a repulsive force F11 of an elastic member such as rubber forming the outer sheath 118 , a contraction force F12 , and a bending reaction force F13 of the internal object 170 .

[0710] Figure 79 1 is a diagram showing the friction force F2 acting on the curved portion 112 .

[0711] The friction force F2 includes friction force F21 between the node rings 115 and friction force F22 between the bending wire 160 and the wire guides (upper wire guide 115u, lower wire guide 115d, left wire guide 115l, and right wire guide 115r).

[0712] Figure 80 Graph showing the relationship between the bending angle θ of the bending portion 112 and the restoring force F1 .

[0713] The bending angle θ is the bending angle of the curved portion 112 measured from the central axis O in the longitudinal direction A of the curved portion 112 in a straight state. The larger the bending angle θ, the greater the restoring force F1. On the other hand, the smaller the bending angle θ, the smaller the restoring force F1. When the bending angle θ is less than a predetermined angle, the restoring force F1 becomes smaller than the friction force F2.

[0714] The curved shape of the curved portion 112 where the restoring force F1 is greater than the friction force F2 (restoring force F1>friction force F2) is referred to as a "first shape." The curved shape of the curved portion 112 where the restoring force F1 is less than the friction force F2 (restoring force F1≦friction force F2) is referred to as a "second shape."

[0715] [First driving mode]

[0716] When the bending portion 112 is bent so that the bending angle θ increases, the drive controller 260I switches the drive mode of the wire drive unit 250C to the first drive mode. Furthermore, when the bending portion 112 is bent so that the bending angle θ decreases and the bent shape of the bending portion 112 is the first shape, the drive controller 260I switches to the first drive mode. In the first drive mode, the drive controller 260I controls the position of the inner diameter bending wire 160 of the pair of opposing bending wires 160 (opposing wires) that bend the bending portion 112 in the UD direction or the LR direction, and controls the tension of the outer diameter bending wire 160.

[0717] The inner diameter side bending line 160 of the opposing lines is located inside the curved portion 112 when viewed from the center of curvature. The outer diameter side bending line 160 of the opposing lines is located outside the curved portion 112 when viewed from the center of curvature.

[0718] The position control is a control method for controlling the pulling amount or feeding amount of the bending wire 160 based on the target position to be moved by bending the bending portion 112 .

[0719] The tension control is a control method for controlling the pulling amount or feeding amount of the bending wire 160 so that the tension of the bending wire 160 matches a predetermined set value.

[0720] When the wire drive unit 250C is in the first drive mode, the drive controller 260I controls the position of the inner diameter bending wire 160, thereby overcoming the restoring force F1 and accurately controlling the bending angle θ. Meanwhile, the drive controller 260I controls the tension of the outer diameter bending wire 160, thereby maintaining the tension of the bending wire 160 at a predetermined set value.

[0721] When the wire drive unit 250C is in the first drive mode, the drive controller 260I controls the position of the inner diameter side bending wire 160, thereby effectively resisting the external reaction force in the direction of increasing the bending angle θ. Therefore, the drive controller 260I can easily bend the bending portion 112 to a large extent, even in a narrow large intestine.

[0722] [Second driving mode]

[0723] When the bending portion 112 is bent so as to reduce the bending angle θ and the bent shape of the bending portion 112 is the second shape, the drive controller 260I switches the drive mode of the wire drive unit 250C to the second drive mode. In the second drive mode, the drive controller 260I controls the tension of the inner diameter bending wire 160 of the pair of opposing bending wires 160 (opposing wires) that bend the bending portion 112 in the UD direction or the LR direction, and controls the position of the outer diameter bending wire 160.

[0724] When the bending portion 112 is bent in the second shape, the drive controller 260I controls the position of the outer diameter side bending wire 160, thereby assisting the restoring force F1, which is smaller than the friction force F2, and preventing a decrease in the bending control speed. Meanwhile, the drive controller 260I controls the tension of the inner diameter side bending wire 160, thereby maintaining the tension of the bending wire 160 at a predetermined set value.

[0725] When the bending shape of the bending portion 112 changes from a first shape to a second shape, etc., the driving mode of the wire driving portion 250C is switched from the first driving mode to the second driving mode. Thus, the driving controller 260I can prevent the decrease in the movement speed of the bending action due to the decrease in the restoring force F1, and can smoothly control the bending action.

[0726] Next, the method of using the electric endoscope system 1000I of this embodiment will be described. Figure 81The control flow chart of the drive controller 260I of the control device 600I shown in FIG. When the control device 600I is started, the drive controller 260I performs initialization and then begins control (step S900). During initialization, the drive controller 260I adjusts the bending wire 160 so that the bending portion 112 is in a straight state and the slack in the bending wire 160 is eliminated. Next, the drive controller 260I (primarily the processor) executes step S910.

[0727] In step S910, the drive controller 260I calculates the bending angle θ. The drive controller 260I calculates the bending angle θ based on feedback information such as the operation history of the bending wire 160 and the tension of the bending wire 160. The drive controller 260I can also estimate the bending angle θ using the observation device 800 described in the eighth embodiment. Next, the drive controller 260I executes step S920.

[0728] In step S920 , the drive controller 260I switches the drive mode of the wire drive unit 250C to either the first drive mode or the second drive mode based on the bending angle θ. Next, the drive controller 260I executes step S930 .

[0729] In step S930, the drive controller 260I obtains the operation input from the operating device 300. When the drive controller 260I obtains the operation input from the operating device 300, step S940 is executed.

[0730] In step S940 , the drive controller 260I controls the wire drive unit 250C based on the drive mode to drive the bending wire 160 to bend the bending portion 112 .

[0731] The drive controller 260I then executes step S950. In step S950, the drive controller 260I determines whether to terminate the control. If the control is not terminated, the drive controller 260I executes step S910 again. If the control is terminated, the drive controller 260I then executes step S960 and terminates the control.

[0732] A portion of the control flow chart of the driving controller 260I described above may also be implemented by the main controller 560 .

[0733] Figures 82 to 87 1 is a diagram showing the controlled bending portion 112 .

[0734] like Figure 82 As shown, when the wire driving unit 250C bends the bending portion so as to increase the bending angle θ, the driving mode of the wire driving unit 250C is set to the first driving mode, the position of the pulling side wire is controlled, and the tension of the delivery side wire is controlled.

[0735] like Figure 83 As shown, when the drive controller 260I bends the bending portion 112 in a manner that reduces the bending angle θ and when the bending shape of the bending portion 112 is the first shape, the drive mode of the wire drive portion 250C is set to the first drive mode, the tension of the wire on the traction side is controlled, and the position of the wire on the delivery side is controlled.

[0736] like Figure 84 As shown, when the drive controller 260I bends the bending portion 112 in a manner that reduces the bending angle θ and when the bending shape of the bending portion 112 is the second shape, the drive mode of the wire drive portion 250C is set to the second drive mode, the position of the wire on the traction side is controlled, and the tension of the wire on the delivery side is controlled.

[0737] like Figure 85 As shown, when bending the straight bending portion 112 to the opposite side, the drive controller 260I sets the drive mode of the wire drive unit 250C to the first drive mode, controls the position of the pulling wire, and controls the tension of the delivery wire.

[0738] At the curved portion 112 Figure 84 The status shown is Figure 85 When the bending is continued in the state shown, the position of the wire on the pulling side is controlled and the tension of the wire on the delivery side is controlled. Therefore, the drive controller 260I can prevent the speed of the bending operation from decreasing and can smoothly control the bending operation.

[0739] like Figure 86 As shown, when the drive controller 260I bends the bending portion 112 in a manner that reduces the bending angle θ and when the bending shape of the bending portion 112 is the first shape, the drive mode of the wire drive portion 250C is set to the first drive mode, the tension of the wire on the traction side is controlled, and the position of the wire on the delivery side is controlled.

[0740] like Figure 87 As shown, when the drive controller 260I bends the bending portion 112 in a manner that reduces the bending angle θ and when the bending shape of the bending portion 112 is the second shape, the drive mode of the wire drive portion 250C is set to the second drive mode, the position of the wire on the traction side is controlled, and the tension of the wire on the delivery side is controlled.

[0741] The electric endoscope system 1000I of this embodiment enables more efficient observation or treatment using the endoscope 100C. Since the endoscope 100C is separated from the operating device 300, the surgeon S can operate the endoscope 100C and the operating device 300 independently without affecting each other.

[0742] As the drive device 200I and the operating device 300 separate, the path of the bending wire 160 from the insertion portion 110 of the endoscope 100C to the drive device 200I may become longer. However, the drive controller 260I performs position control on one side of the opposing wire and tension control on the other side, making it easier to accurately bend the bending portion 112. For example, if both sides of the opposing wire are positionally controlled, slack may occur in one side of the opposing wire due to the difference in the path of the opposing wire. However, because the drive controller 260I controls the tension of the other side of the opposing wire, such slack is prevented.

[0743] The drive controller 260I can determine which of the restoring force F1 and the friction force F2 is dominant in controlling the shape of the bending portion 112 based on the bending shape (bending angle θ) of the bending portion 112. Based on this determination, the drive controller 260I switches the drive mode of the wire drive unit 250C. Consequently, the drive controller 260I can smoothly control the bending motion of the bending portion 112.

[0744] In this embodiment, the target tension in tension control is based on the initial tension at system startup. The initial tension may be set to a low tension that slightly exceeds the frictional force of the long sheath but does not cause slack in the bending wire 160. In other words, the target tension in tension control may be set lower than the pulling tension generated during position control.

[0745] The ninth embodiment of the present invention has been described in detail with reference to the accompanying drawings, but the specific structure is not limited to this embodiment and includes design changes within the scope of the present invention. In addition, the structural elements shown in the above-mentioned embodiments and modifications can be appropriately combined to form a structure.

[0746] (Variation 9-1)

[0747] In the above embodiment, the shape of the curved portion 112 is determined based solely on the bending angle θ as a "first shape" in which the restoring force F1 is greater than the friction force F2, and a "second shape" in which the restoring force F1 is less than the friction force F2. However, the method of determining the first shape and the second shape is not limited to this. In addition to the bending angle θ, the shape of the curved portion 112 can also be determined based on the traction state of all the bending lines 160. For example, when the first curved portion 113 and the second curved portion 114 are bent in the same direction, the restoring force F1 for the bending angle θ becomes greater than when only one of them is bent. In this case, the drive controller 260I can also change the threshold value of the bending angle θ that serves as the basis for determining the first shape and the second shape.

[0748] (Variation 9-2)

[0749] In the above embodiment, the shape of the curved portion 112 is determined based solely on the bend angle θ as either a "first shape" in which the restoring force F1 is greater than the friction force F2 or a "second shape" in which the restoring force F1 is less than the friction force F2. However, the method for determining the first and second shapes is not limited to this. In addition to the bend angle θ, the shape of the curved portion 112 can also be determined based on the tension of the opposing wires. For example, if the tension of the inner diameter bending wire 160, which is position-controlled in the first drive mode, falls below the predetermined set value of the outer diameter bending wire 160, the curved portion 112 can be determined to have changed to the second shape, and the second drive mode can be switched.

[0750] (Tenth embodiment)

[0751] Reference Figures 88 to 91 A tenth embodiment of the electric endoscope system 1000J according to the present invention will be described. In the following description, the same reference numerals are given to the same components as those already described, and duplicate descriptions will be omitted. Figure 88 It is an overall view of an electric endoscope system 1000J according to this embodiment.

[0752] [Electric Endoscope System 1000J]

[0753] like Figure 88 As shown, an electric endoscope system 1000J is a medical system for observing and treating the body of a patient P lying on an operating table T. The electric endoscope system 1000J includes an endoscope 100 , a driving device 200 , an operating device 300J, a treatment instrument 400 , an image control device 500 , and a display device 900 .

[0754] [Operating device 300J]

[0755] Figure 89 It is a perspective view of the operating device 300J.

[0756] The operating device 300J is a device for inputting operations for driving the endoscope 100. The inputted operations are transmitted to the driving device 200 via the operating cable 301. The operating device 300J can also communicate with the driving device 200 via wireless communication rather than wired communication. The operating device 300J has an input unit different from that of the operating device 300 of the first embodiment.

[0757] The operating device 300J includes an operating unit body 310J and a touch panel 380. The operating device 300J does not include the first angle knob 320, the second angle knob 330, the switch 340, the air supply button 350, the suction button 351, and the various buttons 352. Figure 88 The illustrated operating device 300J is equipped with a second forceps jaw fixing device 360 ​​.

[0758] The operation unit body 310J is formed into a substantially cylindrical shape that can be held by the left hand L of the operator S. Figure 89 As shown, the operation unit body 310J has a back surface 311 that allows the palm of the left hand L of the surgeon S to rest along it. The operation unit body 310J includes a touchpad support portion 314 extending from a front surface 312 opposite to the back surface 311. An operation cable 301 is connected to the longitudinal end of the operation unit body 310J.

[0759] In the following description, the direction in which the touchpad support portion 314 extends relative to the operation unit main body 310J is defined as the "front-back direction", and the direction in which the touchpad support portion 314 is provided relative to the operation unit main body 310J is defined as the "front FR". The opposite direction thereof is defined as the "rear RR". In addition, the longitudinal direction of the operation unit main body 310J is defined as the "upper-lower direction", and the direction in which the operation cable 301 is attached relative to the operation unit main body 310J is defined as the "lower direction LWR". The opposite direction thereof is defined as the "upper direction UPR". The right direction when facing the rear RR is defined as the "right RH". The opposite direction thereof is defined as the "left LH". The direction toward the right RH or the left LH is defined as the "left-right direction".

[0760] In the present embodiment, the direction in which the touchpad support portion 314 extends relative to the operation unit body 310J (front-back direction) is a direction substantially perpendicular to the back surface 311 of the operation unit body 310J.

[0761] The touchpad support portion 314 supports the touchpad 380. The touchpad support portion 314 is provided on the left side LH on the front surface 312 of the operation unit main body 310J when viewed from the front side FR toward the rear side RR.

[0762] The touchpad 380 is provided on the left LH side of the touchpad support portion 314. The touchpad 380 faces the left LH. The touchpad 380 is provided at a position that is easily operated by the thumb of the left hand L of the operator S holding the operation unit body 310J.

[0763] The touchpad 380 has divided operation areas. The division of the operation areas in the touchpad 380 can be changed by setting a mode. In this embodiment, the touchpad 380 can be set to either a first mode or a second mode.

[0764] Figure 90This is a side view of the operating device 300J with the touchpad 380 set to the first mode. In the first mode, the touchpad 380 is divided into a first angle operation area R11, a second angle operation area R12, a switching operation area R13, an air supply operation area R14, a suction operation area R15, and a various operation area R16.

[0765] The first and second angle operation areas R11 and R12 are rectangular areas extending in the vertical direction. The first and second angle operation areas R11 and R12 are arranged side by side in the front-to-back direction. The first angle operation area R11 is arranged at the rear RR, and the second angle operation area R12 is arranged at the front FR.

[0766] The first angle operation area R11 is an area for inputting operations equivalent to those of the first angle knob 320 in the first embodiment. By moving the thumb in contact with the first angle operation area R11 upward (UPR), an operation equivalent to rotating the first angle knob 320 clockwise when viewed from the front (FR) toward the rear (RR) is input. By moving the thumb in contact with the first angle operation area R11 downward (LWR), an operation equivalent to rotating the first angle knob 320 counterclockwise when viewed from the front (FR) toward the rear (RR) is input. Operations input into the first angle operation area R11 are transmitted to the drive device 200.

[0767] The second angle operation area R12 is an area for inputting operations equivalent to those of the second angle knob 330 in the first embodiment. By moving the thumb in contact with the second angle operation area R12 upward UPR, an operation equivalent to rotating the second angle knob 330 clockwise when viewed from the front FR toward the rear RR is input. By moving the thumb in contact with the second angle operation area R12 downward LWR, an operation equivalent to rotating the second angle knob 330 counterclockwise when viewed from the front FR toward the rear RR is input. Operations input into the second angle operation area R12 are transmitted to the drive device 200.

[0768] like Figure 19 and Figure 90 As shown, when viewed from the left side LH toward the right side RH, the first angle operating area R11 is located at a position equivalent to the first angle knob 320 of the operating device 300 of the first embodiment. Furthermore, when viewed from the left side LH toward the right side RH, the second angle operating area R12 is located at a position equivalent to the second angle knob 330 of the operating device 300 of the first embodiment. Therefore, the surgeon S can operate the first angle operating area R11 and the second angle operating area R12 in the same manner as the first angle knob 320 and the second angle knob 330.

[0769] The switching operation area R13, the air supply operation area R14, the suction operation area R15, and the various operation areas R16 are arranged in order from the upper UPR to the lower LWR.

[0770] The switching operation region R13 is a region in which an operation equivalent to the operation of the switch 340 of the first embodiment is input. The operation input to the switching operation region R13 is transmitted to the drive device 200.

[0771] The air supply operation region R14 is a region for inputting an operation equivalent to the operation on the air supply button 350 of the first embodiment. The operation input to the air supply operation region R14 is transmitted to the drive device 200.

[0772] The suction operation region R15 is a region for inputting an operation equivalent to the operation on the suction button 351 of the first embodiment. The operation input to the suction operation region R15 is transmitted to the driving device 200.

[0773] The various operation regions R16 are regions for inputting operations equivalent to the operations on the various buttons 352 of the first embodiment. The operations inputted to the various operation regions R16 are transmitted to the drive device 200.

[0774] Figure 91 3 is a side view of the operating device 300J with the touchpad 380 set to the second mode. In the second mode, the touchpad 380 is divided into an angle operation area R10, a switching operation area R13, an air supply operation area R14, a suction operation area R15, and various operation areas R16.

[0775] The angle operation region R10 is a rectangular region in which operations equivalent to those of the first angle knob 320 and the second angle knob 330 in the first embodiment are input. Operations input to the angle operation region R10 are transmitted to the drive device 200 .

[0776] By moving the thumb in contact with the angle operation area R10 in the direction (first direction) D1 along the up-down direction, an operation equivalent to the operation of the first angle knob 320 in the first embodiment is input. The touchpad 380 associates the input in the direction (first direction) D1 in the angle operation area R10 with an operation to bend the first bending portion 113 or the second bending portion 114 in the UD direction. By moving the thumb in contact with the angle operation area R10 upward along the direction D1 UPR, an operation to bend the first bending portion 113 or the second bending portion 114 upward in the UD direction is input. By moving the thumb in contact with the angle operation area R10 downward along the direction D1 LWR, an operation to bend the first bending portion 113 or the second bending portion 114 downward in the UD direction is input.

[0777] By moving the thumb in contact with the angle operation area R10 in the direction (second direction) D2 along the front-back direction, an operation equivalent to the operation on the second angle knob 330 of the first embodiment is input. The touchpad 380 associates input in the direction (second direction) D2 within the angle operation area R10 with an operation to bend the first bending portion 113 or the second bending portion 114 in the LR direction. By moving the thumb in contact with the angle operation area R10 toward the front FR (right side of the touchpad 380) along the direction D2, an operation to bend the first bending portion 113 or the second bending portion 114 rightward in the LR direction is input. By moving the thumb in contact with the angle operation area R10 toward the rear RR (left side of the touchpad 380) along the direction D2, an operation to bend the first bending portion 113 or the second bending portion 114 leftward in the LR direction is input.

[0778] The surgeon S can intuitively bend the first bending portion 113 or the second bending portion 114 by moving the thumb in contact with the angle manipulation area R10 in directions D1 and D2. Furthermore, direction D1 is not limited to the vertical direction or the horizontal direction but may also include directions inclined from the vertical direction. Furthermore, direction D2 is not limited to the front-back direction or the horizontal direction but may also include directions inclined from the front-back direction.

[0779] The switching operation area R13, the air supply operation area R14, the suction operation area R15, and the various operation areas R16 are arranged in order from the rear RR to the front FR.

[0780] The electric endoscope system 1000J of this embodiment allows for more efficient observation or treatment using the endoscope 100. Since the endoscope 100 is separate from the operating device 300J, the surgeon S can independently operate the endoscope 100 and the operating device 300J without affecting each other.

[0781] An operation area for switching the mode setting to either the first mode or the second mode may be provided on the touchpad 380. The surgeon S can switch the mode setting of the touchpad 380 by operating the touchpad 380.

[0782] According to the electric endoscope system 1000J of this embodiment, the operating device 300J has no movable parts such as buttons or switches, making it easy to clean. Furthermore, due to its small number of components, the operating device 300J is compact and lightweight. This makes it easy for the surgeon S to operate the operating device 300J by simply holding it with his left hand L.

[0783] The electric endoscope system 1000J of this embodiment can switch between a first mode and a second mode. In the first mode, operation can be performed using a method similar to conventional endoscope operation. In the second mode, the input of bending operations in the UD / LR directions corresponds to the direction of bending of the bending portion 112, allowing intuitive operation. For example, an experienced physician accustomed to conventional endoscope operation methods or a physician who wishes to independently input bending operations in the UD / LR directions can use the operating device 300J by setting the mode to the first mode. Furthermore, interns who are about to learn endoscope operation can switch to the appropriate operating mode and use the operating device 300J.

[0784] For example, if the display device 900 is equipped with a touch panel, the surgeon needs to touch the screen of the display device 900 displaying the endoscopic image, which can sometimes make it difficult to view the endoscopic image due to the finger performing the touching operation. However, the electric endoscope system 1000J, equipped with a touchpad 380 on the operating device 300J, does not present the aforementioned difficulty in viewing the endoscopic image. Furthermore, the surgeon S can move the touchpad 380 in coordination with the endoscopic image displayed on the screen of the display device 900, easily aligning directions D1 and D2 with the vertical and horizontal directions in the endoscopic image of the endoscope 100. Furthermore, the surgeon S can touch the touchpad 380 in a free manner while away from the screen of the display device 900. For these reasons, the surgeon S can more intuitively operate the touchpad 380 of the operating device 300J.

[0785] The tenth embodiment of the present invention has been described in detail with reference to the accompanying drawings, but the specific structure is not limited to this embodiment and includes design changes within the scope of the present invention. In addition, the structural elements shown in the above-mentioned embodiments and modifications can be appropriately combined to form.

[0786] (Variation 10-1)

[0787] In the above embodiment, the operating device 300J includes a touchpad 380 for inputting operations. However, the operating device 300J is not limited to this embodiment. The touchpad 380 of the operating device 300J may also be a touchpad with a display such as a liquid crystal panel. By displaying the operation area (R11 to R16) of the touchpad 380 on the display, the surgeon S can easily grasp the location of the operation area (R11 to R16).

[0788] (Variation 10-2)

[0789] In the above embodiment, the operating device 300J does not include movable buttons or switches, but the form of the operating device 300J is not limited to this. Figure 92 300JA is a perspective view showing a modified example of the operating device 300J. The operating device 300JA further includes a selector switch 340, an air supply button 350, a suction button 351, and various buttons 352 in addition to the operating device 300J.

[0790] (Eleventh embodiment)

[0791] Reference Figures 93 to 94 An electric endoscope system 1000K according to an eleventh embodiment of the present invention will be described. In the following description, the same reference numerals are given to the same components as those already described, and duplicate descriptions will be omitted. Figure 93 It is an overall view of the electric endoscope system 1000K according to this embodiment.

[0792] [Electric Endoscope System 1000K]

[0793] like Figure 93 As shown, an electric endoscope system 1000K is a medical system for observing and treating the body of a patient P lying on an operating table T. The electric endoscope system 1000K includes an endoscope 100, a drive device 200, an operating device 300K, a treatment instrument 400, an image control device 500, and a display device 900. The treatment instrument 400 is inserted from the forceps opening 126 of the connecting portion 120 into the channel tube 171 of the endoscope 100 without passing through the extension channel tube 130.

[0794] [Operating device 300K]

[0795] Figure 94 It is a perspective view of the operating device 300K.

[0796] The operating device 300K is a device for inputting operations for driving the endoscope 100. The inputted operations are transmitted to the driving device 200 via the operating cable 301. The operating device 300K can also communicate with the driving device 200 via wireless communication rather than wired communication. The operating device 300K has an input unit different from that of the operating device 300 of the first embodiment.

[0797] The operation device 300K includes an operation unit body 310K, a first joystick 321 , a second joystick 322 , a third joystick 323 , a first button 350K, a second button 351K, and a third button 352K.

[0798] The operating unit body 310K is shaped like a game controller. It includes a main body 315, a right handle 316, and a left handle 317. The main body 315 is positioned between the right handle 316 and the left handle 317. The surgeon S holds the operating device 310K by gripping the right handle 316 with his right hand R and the left handle 317 with his left hand L.

[0799] In the following description, the direction toward the surgeon S when the surgeon S holds the right handle 316 with the right hand R and the left handle 317 with the left hand L is defined as "forward FR". The opposite direction is defined as "rear RR". The direction toward the front FR or the rear RR is defined as the "front-back direction". The direction in which the right handle 316 is installed relative to the operating unit main body 310K is defined as the "right RH". The direction in which the left handle 317 is installed relative to the operating unit main body 310K is defined as the "left LH". The direction toward the right RH or the left LH is defined as the "left-right direction". The upward direction when toward the rear RR is defined as the "upper UPR". The opposite direction is defined as the "lower LWR". The direction toward the upper UPR or the lower LWR is defined as the "upper-lower direction".

[0800] A first joystick 321, a second joystick 322, a third joystick 323, a switch 340K, a first button 350K, a second button 351K, and a third button 352K are arranged on the front surface 312 of the main body 315. The surgeon S mainly operates the first joystick 321, the first button 350K, etc. with his thumb.

[0801] The first joystick 321 is used to input operations for bending the first bending section 113 in the UD and LD directions, similar to the operations input in the first bending section control mode M1 of the second embodiment. The operator S inputs operations for bending the first bending section 113 in the UD direction by moving the first joystick 321 vertically. When the operator S moves the first joystick 321 horizontally, operations for bending the first bending section in the LR direction are input. The operations input to the first joystick 321 are transmitted to the drive device 200.

[0802] The second joystick 322 is used to input operations for bending the second bending section 114 in the UD and LD directions, similar to the operations input in the second bending section control mode M2 ​​of the second embodiment. The operator S inputs operations for bending the second bending section 114 in the UD direction by moving the second joystick 322 in the vertical direction. When the operator S moves the second joystick 322 in the horizontal direction, operations for bending the second bending section 114 in the LR direction are input. The operations input to the second joystick 322 are transmitted to the drive device 200.

[0803] The third joystick 323 is used to input operations for coordinated bending of the first and second bending sections 113, 114 in the UD and LD directions, similar to the operations input in the coordinated control mode M3 of the second embodiment. The operator S inputs operations for coordinated bending of the first and second bending sections 113, 114 in the UD directions by moving the third joystick 323 vertically. When the operator S moves the third joystick 323 horizontally, operations for coordinated bending of the first and second bending sections 113, 114 in the LR directions are input. The operations input to the third joystick 323 are transmitted to the drive device 200.

[0804] The first button 350K is a button for inputting an operation equivalent to the operation on the air supply button 350 of the first embodiment. The operation input to the first button 350K is transmitted to the driving device 200.

[0805] The second button 351K is a button for inputting an operation equivalent to the operation of the suction button 351 of the first embodiment. The operation input to the second button 351K is transmitted to the driving device 200.

[0806] The third button 352K is a button for inputting an operation equivalent to the operation of the various buttons 352 of the first embodiment. The operation input to the third button 352K is transmitted to the driving device 200.

[0807] The first joystick 321 and the second joystick 322 are arranged at positions where they can be operated with the thumb of the left hand L when the operator S grips the left handle 317 with his left hand L. Therefore, even when the operator S removes his right hand R from the operating device 300K to operate the insertion portion 110 of the endoscope 100, he can still input an operation to bend the first bending portion 113 and the second bending portion 114.

[0808] The first joystick 321 for operating the first bending portion 113 is located above UPR and distal to the second joystick 322 for operating the second bending portion 114 . Therefore, the surgeon S can intuitively distinguish between the first joystick 321 and the second joystick 322 .

[0809] According to the electric endoscope system 1000K of this embodiment, operation inputs corresponding to each bending mode can be input to the operating device 300K without switching the bending mode. By being familiar with the operation inputs for the first joystick 321 and the like, the surgeon S can quickly input complex operation inputs without switching the bending mode.

[0810] The eleventh embodiment of the present invention has been described in detail with reference to the accompanying drawings, but the specific structure is not limited to this embodiment and also includes design changes within the scope of the present invention. In addition, the structural elements shown in the above-mentioned embodiments and modifications can be appropriately combined and configured.

[0811] (Variation 11-1)

[0812] In the above embodiment, the operational inputs assigned to the first joystick 321 or the first button 350K are fixed. However, the assignment of operational inputs to the first joystick 321 or the first button 350K is not limited to this. The assignment of operational inputs to the first joystick 321 or the first button 350K can also be changed. For example, the assignment of operational inputs can be changed by switching the switch 340K or the like, depending on the surgeon's S preference, so that an operation to bend the second bending portion 114 is input to the first joystick 321, and an operation to bend the first bending portion 113 is input to the second joystick 322. Furthermore, the assignment of operational inputs can be changed by switching the switch 340K or the like, depending on the surgeon's S preference, so that an operation equivalent to the suction button 351 in the first embodiment is input to the first button 350K, and an operation equivalent to the air supply button 350 in the first embodiment is input to the second button 351K.

[0813] (Variation 11-2)

[0814] In the above embodiment, the operating device 300K includes a joystick and buttons. However, the operation input unit of the operating device 300K is not limited thereto. The operating device 300K may include a sensor such as a gyro sensor or an acceleration sensor as the operation input unit.

[0815] (Variation 11-3)

[0816] The shape of the operating device 300K and the arrangement of the operation input units (joystick, buttons) included in the operating device 300K are not limited to the above-described embodiment. The operating device 300K may have multiple variations with different shapes and arrangement of the operation input units. The surgeon S can select and use an operating device 300K that is easier to use from among the multiple variations.

[0817] When multiple variant operating devices 300K are connected to the drive device 200, it is desirable for the operating device 300K to include a safety mechanism that indicates that the operating device 300K has been certified for compatibility and safety with the drive device 200. The safety mechanism is appropriately selected from among well-known security mechanisms such as a security chip. The drive device 200 can determine whether the operating device 300K connected to the drive device 200 is certified based on the presence or absence of the safety mechanism. If the operating device 300K includes a safety mechanism, it can prevent operating devices 300K whose compatibility and safety have not been certified from being connected to the drive device 200 and used.

[0818] (Twelfth embodiment)

[0819] Reference Figures 95 to 100 An electric endoscope system 1000L according to a twelfth embodiment of the present invention will be described. In the following description, the same reference numerals are given to the same components as those already described, and duplicate descriptions will be omitted. Figure 95 It is an overall view of the electric endoscope system 1000L according to this embodiment.

[0820] [Electric Endoscope System 1000L]

[0821] like Figure 95 As shown, an electric endoscope system 1000L is a medical system for observing and treating the body of a patient P lying on an operating table T. The electric endoscope system 1000L includes an endoscope 100, a drive device 200, an operating device 300L, a treatment instrument 400, an image control device 500, and a display device 900. The treatment instrument 400 is inserted from the forceps opening 126 of the connecting portion 120 into the channel tube 171 of the endoscope 100 without passing through the extension channel tube 130.

[0822] [Operating device 300L]

[0823] The operating device 300L is a device for inputting an operation for driving the endoscope 100. The input operation is transmitted to the driving device 200 via wireless communication. The operating device 300L is not connected to the driving device 200 via the operating cable 301.

[0824] Figure 96 This is a perspective view of the operating device 300L as viewed from the back surface 311 .

[0825] The operating device 300L includes an operating portion main body 310 , a first angle knob 320 , a second angle knob 330 , a changeover switch 340 , an air supply button 350 , a suction button 351 , various buttons 352 , and a mount adapter 390 .

[0826] The mounting adapter 390 is an adapter that detachably mounts the operating unit body 310 to the external flexible portion 140. When the operating device 300L is not mounted on the external flexible portion 140 and is held by the operator S, the mounting adapter 390 is removed from the operating unit body 310. The mounting adapter 390 includes a first mounting portion 391 and a second mounting portion 392.

[0827] The first mounting portion 391 mounts the mounting adapter 390 to the back surface 311 of the operation unit body 310 using screws 391a, for example. Alternatively, the first mounting portion 391 may mount the mounting adapter 390 to the back surface 311 of the operation unit body 310 using adhesive tape or the like.

[0828] Figure 97 It is a perspective view of the operation device 300L attached to the external flexible part 140 .

[0829] The second mounting portion 392 removably attaches the mounting adapter 390 to the external flexible portion 140. The second mounting portion 392 is formed into a generally cylindrical shape capable of retaining the external flexible portion 140 on its inner circumference, and includes a slit 392b extending along its longitudinal axis. The surgeon S elastically deforms the second mounting portion 392 to widen the slit 392b, allowing the external flexible portion 140 to pass through. This allows the second mounting portion 392 to be attached to and detached from the external flexible portion 140.

[0830] Figure 98 This is a diagram for explaining how to use the electric endoscope system 1000L.

[0831] Next, a method of using the electric endoscope system 1000L of this embodiment will be described. The surgeon S attaches the operating device 300L to the external flexible portion 140. The surgeon S can hold the operating device 300L with his left hand L while also holding the external flexible portion 140.

[0832] The surgeon S moves the insertion portion 110 by operating the internal soft part 119 with his right hand R while observing the camera image displayed on the display device 900. Furthermore, the surgeon S operates the first angle knob 320 and the second angle knob 330 of the operating device 300L with his left hand L to bend the bending portion 112 as needed.

[0833] like Figure 98 As shown, while the surgeon S manipulates the internal soft part 119 with his right hand R and moves the insertion portion 110, he holds the external soft part 140 with his left hand L. Thus, the surgeon S can use his left hand L to move the external soft part 140 forward and backward, thereby assisting the manipulation of the internal soft part 119 by his right hand R. As a result, the surgeon S can more appropriately manipulate the internal soft part 119 than when manipulating the internal soft part 119 only with his right hand R.

[0834] According to the electric endoscope system 1000L of this embodiment, observation or treatment using the endoscope 100 can be performed more efficiently. Although the endoscope 100 is separated from the operating device 300L, the operating device 300L is attached to the endoscope 100 via the mounting adapter 390. The surgeon S can simultaneously hold the operating device 300L and the external flexible portion 140 with his left hand L. In addition, the surgeon S can use his left hand L to move the external flexible portion 140 forward and backward to assist the right hand R in operating the internal flexible portion 119. In addition, since the operating device 300L is attached to the external flexible portion 140, the surgeon S can remove his left hand L from the operating device 300L and use it to perform other operations.

[0835] The twelfth embodiment of the present invention has been described in detail with reference to the accompanying drawings, but the specific structure is not limited to this embodiment and also includes design changes within the scope of the present invention. In addition, the structural elements shown in the above-mentioned embodiment and modification examples can be appropriately combined to form.

[0836] (Variation 12-1)

[0837] In the above embodiment, the mounting adapter 390 is detachably mounted on the external flexible portion 140. However, the mounting method of the mounting adapter 390 is not limited thereto. Figure 99 300L is a diagram showing a different way of attaching the mounting adapter 390 of the operation device 300L. For example, the mounting adapter 390 may be detachably attached to the internal soft portion 119.

[0838] (Variation 12-2)

[0839] In the above embodiment, the operation unit main body 310 and the mounting adapter 390 are formed separately. However, the operation unit main body 310 and the mounting adapter 390 may be formed integrally.

[0840] (Variation 12-3)

[0841] In the above embodiment, the operating device 300L is obtained by attaching the mounting adapter 390 to the operating device 300 of the first embodiment. However, the form of the operating device 300L is not limited to this. Figure 100 1 is a diagram illustrating an operating device 300LA, which is a modified example of the operating device 300L. The operating device 300LA includes an operating unit body 310LA, a joystick 320LA, and a mounting adapter 390. The operating unit body 310LA is compact and easily grasped with the left hand L alone. The joystick 320LA is provided on the operating unit body 310LA, and inputs operations equivalent to those performed on the first joystick 321 or the second joystick 322. The mounting adapter 390 detachably mounts the operating unit body 310LA to the external flexible portion 140. Because the operating device 300LA is compact, the operator S can easily operate the joystick 320LA even while holding both the operating device 300LA and the external flexible portion 140 with his left hand L.

[0842] Because the left hand L can easily grasp the operating device 300LA, the surgeon S can easily assist the right hand R in inserting the soft part 119 into the body by applying a twisting force with the left hand L. Alternatively, after the insertion portion 110 reaches the affected area, the surgeon S can use the operating device 300L instead of the operating device 300LA. For both observing and treating the affected area, the multifunctional operating device 300L is more suitable than the compact operating device 300LA. By tailoring the operating device to each surgical scenario, for example, it is possible to achieve both the insertability and therapeutic properties of the endoscope 100.

[0843] (Variation 12-4)

[0844] The electric endoscope system 1000L may also have a second operating device having an input unit different from the operating device 300L (first operating device). The operating device 300L and the second operating device can perform operation inputs at the same time. By providing the second operating device, for example, when an intern uses the operating device 300L to perform an operation, the supervising doctor can use the second operating device to intervene in the operation. The drive device 200 can accept inputs from the operating device 300L and the second operating device at the same time. The operating device 300L and the second operating device can perform operation inputs at the same time, but it can also be set so that when operations are input at the same time, the drive device 200 gives priority to the supervising doctor side. The drive device 200 can also selectively accept operation signals from the operating device 300L and the second operating device. The selection of the above-mentioned operation signals can be changed by the setting of the drive device 200.

[0845] The program in each embodiment can also be recorded on a computer-readable recording medium, and realized by making a computer system read and execute the program recorded on the recording medium. In addition, "computer system" includes hardware such as OS and peripheral devices. In addition, "computer-readable recording medium" refers to removable media such as floppy disks, optical magnetic disks, ROMs, CD-ROMs, and storage devices such as hard disks built into the computer system. In addition, "computer-readable recording medium" can also include a recording medium that dynamically stores the program in a short time, such as a communication line when sending a program via a network such as the Internet or a communication line such as a telephone line, or a recording medium that stores the program for a certain period of time, such as a volatile memory inside a computer system that becomes a server or client in this case. In addition, the above-mentioned program can be used to realize a part of the above-mentioned functions, and can also realize the above-mentioned functions by combining with a program already recorded in the computer system.

[0846] Industrial applicability

[0847] The present invention can be applied to a medical system for observing and treating the inside of a lumen organ or the like.

[0848] Description of Reference Numerals

[0849] 1000, 1000C Electric endoscope systems, surgical support systems, medical systems

[0850] 100 Endoscope

[0851] 110 Insertion

[0852] 111 front end

[0853] 112 Bend

[0854] 113 First bend

[0855] 114 Second bend

[0856] 119 Soft parts of the body

[0857] 140 External soft part

[0858] 150 Loading and Unloading Department

[0859] 200, 200C drive unit

[0860] 300 operating device

[0861] 400 Disposal Equipment

[0862] 500 Image Control Device

[0863] 600, 600C control unit [0864...

Claims

1. A medical system, wherein: The medical system has: A medical device including an insertion portion having a curved portion and a curved wire having a distal end attached to a distal end side of the curved portion; and a driving device detachably connected to the medical device, which electrically drives the bending wire to bend the bending portion; The bending line includes a first bending line and a second bending line, When the medical device is not mounted on the driving device, the first bending wire and the second bending wire are in a loop state in which the base end of the first bending wire and the base end of the second bending wire are mechanically connected. When the medical device is mounted on the driving device, the first bending wire and the second bending wire are in an opposing state in which the proximal end of the first bending wire and the proximal end of the second bending wire are independently driven electrically.

2. The medical system according to claim 1, wherein: The first bending line and the second bending line are a pair of lines that bend the bending portion vertically or horizontally.

3. The medical system according to claim 1 or 2, wherein: The medical device has a detachable portion for attaching and detaching relative to the driving device. The loading and unloading part has a switching mechanism, When the detachable portion is not attached to the drive device, the switching mechanism switches the first bending wire and the second bending wire to the loop state. The switching mechanism switches the first bending wire and the second bending wire to the opposing state when the attaching and detaching portion is attached to the driving device.

4. The medical system according to claim 3, wherein: The attaching and detaching section includes a first rotating drum around which the first bending wire is wound, and a second rotating drum around which the second bending wire is wound. The driving device to which the attaching and detaching portion is attached drives the first bending wire by rotating the first rotating drum, and drives the second bending wire by rotating the second rotating drum.

5. The medical system according to claim 4, wherein: The switching mechanism rotates the first rotating drum and the second rotating drum in conjunction with each other to form the first bending wire and the second bending wire into the loop state. The switching mechanism causes the first bending wire and the second bending wire to be in the opposing state by independently rotating the first rotating drum and the second rotating drum.

6. The medical system according to claim 5, wherein: The switching mechanism has a gear, When the gear is located at the first position, the first rotating drum and the second rotating drum are connected to each other so as to rotate in conjunction with each other. When the gear is located at the second position, the first rotating drum and the second rotating drum are not coupled.

7. The medical system according to claim 6, wherein: The gear moves to the first position when the mounting and dismounting portion is not mounted on the driving device. The gear moves to the second position by being coupled to a portion of the drive device when the attaching and detaching portion is attached to the drive device.

8. The medical system according to claim 7, wherein: The loading and unloading portion further comprises an elastic member, The gear is arranged in the first position by the urging force of the elastic member.

9. A medical device comprising an insertion portion having a curved portion and a curved wire having a distal end mounted on the curved portion, wherein: The medical device is detachably connected to a driving device, and the driving device electrically drives the bending wire to bend the bending portion. The bending line includes a first bending line and a second bending line, When the medical device is not mounted on the driving device, the first bending wire and the second bending wire are in a loop state in which the base end of the first bending wire and the base end of the second bending wire are mechanically connected. When the medical device is mounted on the driving device, the first bending wire and the second bending wire are in an opposing state in which the proximal end of the first bending wire and the proximal end of the second bending wire are independently driven electrically.

10. The medical device according to claim 9, wherein The first bending line and the second bending line are a pair of lines that bend the bending portion vertically or horizontally.

11. The medical device according to claim 9, wherein The medical device has a detachable portion for attaching and detaching relative to the driving device. The loading and unloading portion has a switching mechanism, which switches the first bending line and the second bending line to the ring state when the loading and unloading portion is not assembled to the driving device, and switches the first bending line and the second bending line to the antagonistic state when the loading and unloading portion is assembled to the driving device.

12. The medical device according to claim 11, wherein The attaching and detaching section includes a first rotating drum around which the first bending wire is wound, and a second rotating drum around which the second bending wire is wound. The driving device to which the attaching and detaching portion is attached drives the first bending wire by rotating the first rotating drum, and drives the second bending wire by rotating the second rotating drum.

13. The medical device according to claim 12, wherein The switching mechanism rotates the first rotating drum and the second rotating drum in conjunction with each other to form the first bending wire and the second bending wire into the loop state. The switching mechanism causes the first bending wire and the second bending wire to be in the opposing state by independently rotating the first rotating drum and the second rotating drum.

14. The medical device according to claim 13, wherein The switching mechanism has a gear, When the gear is located at the first position, the gear couples the first rotating drum and the second rotating drum so as to rotate in conjunction with each other. When the gear is located at the second position, the first rotating drum and the second rotating drum are not coupled together.

15. The medical device according to claim 14, wherein The gear moves to the first position when the mounting and dismounting portion is not mounted on the driving device. The gear moves to the second position by being coupled to a portion of the drive device when the attaching and detaching portion is attached to the drive device.

16. The medical device according to claim 15, wherein The loading and unloading portion further comprises an elastic member, The gear is arranged in the first position by the urging force of the elastic member.

17. A driving device for bending a bending portion by electrically driving a first bending wire and a second bending wire of a medical device, the medical device comprising an insertion portion having the bending portion, and the first bending wire and the second bending wire having distal ends attached to the bending portion, wherein: The driving device includes a coupling member capable of coupling with the switching mechanism of the medical device according to claim 15 when the medical device and the driving device are connected.

Images