Endoscope system, control device, and information processing method

Abstract

An endoscope system outputs a user's use condition of an endoscope, the endoscope system including the endoscope and a processor, the endoscope having at least two bending modes, the endoscope having an operation section capable of selecting the at least two bending modes, the processor acquiring a case identifier corresponding to a case in which the endoscope is used, generating use condition information relating to a used bending mode, and outputting the case identifier in association with the use condition information.

Description

TECHNICAL FIELD

[0001] The present application relates to an endoscope system, a control device, and an information processing method each provided with an endoscope. This application claims priority based on U.S. Provisional Application No. 62 / 961,872 filed on January 16, 2020 in the United States, the contents of which are hereby incorporated by reference. BACKGROUND

[0002] Conventionally, an endoscope is used in observation or treatment in a tubular organ such as a digestive tract. A medical system in which observation or treatment using an endoscope is performed more efficiently is desired. For example, a medical system in which a surgeon using an endoscope is less likely to be fatigued and is easy to use for an inexperienced surgeon is desired.

[0003] In Patent Literature 1, an electric bending endoscope provided with an insertion section that is bent by being driven electrically is described. The insertion section of the electric bending endoscope described in Patent Literature 1 is bent by being driven electrically, and thus, a surgeon is less likely to be fatigued.

[0004] PRIOR ART DOCUMENTS

[0005] PATENT LITERATURE

[0006] Patent Literature 1: Japanese Patent No. 4823697 SUMMARY

[0007] PROBLEMS TO BE SOLVED BY THE INVENTION

[0008] However, the electric bending endoscope described in Patent Literature 1 is a medical system in which an insertion section is driven electrically to reduce fatigue of a surgeon to some extent, but is not always easy to use for a surgeon, and is not a medical system in which observation or treatment is performed more efficiently.

[0009] In view of the above, an object of the present application is to provide an endoscope system (medical system), a control device, and an information processing method in which observation or treatment using an endoscope is performed more efficiently.

[0010] MEANS FOR SOLVING PROBLEMS

[0011] To solve the above problems, the present application proposes the following solutions.

[0012] The endoscope system of the first aspect of the present application outputs a usage state of an endoscope by a user, the endoscope system including the endoscope having at least two bending modes, the endoscope having an operation section capable of selecting the at least two bending modes, and a processor that performs processing of acquiring a case identifier corresponding to a case in which the endoscope is used, generating usage state information related to a used bending mode, and outputting the case identifier in association with the usage state information.

[0013] The endoscope system of the second aspect of the present application outputs billing information corresponding to a usage state of an endoscope by a user, the endoscope system including the endoscope and a processor that performs processing of acquiring a case identifier corresponding to a case in which the endoscope is used, detecting a state in which a function that is a billing object is used, not generating new billing information associated with the case identifier in a case where billing information associated with the case identifier is generated, and newly generating and outputting billing information associated with the case identifier in a case where the state in which the function is used is detected and billing information associated with the case identifier is not generated.

[0014] Effects of the Invention

[0015] The endoscope system (medical system) according to the present application can more effectively perform observation or treatment using an endoscope. BRIEF DESCRIPTION OF DRAWINGS

[0016] FIG. 1 is a whole view of an electric endoscope system of a first embodiment.

[0017] FIG. 2 is a view showing an endoscope and an operation device of the electric endoscope system used by a surgery doctor.

[0018] FIG. 3 is a view showing an insertion section of the endoscope.

[0019] FIG. 4 is a view showing a part of a bending section of the endoscope as a cross-sectional view.

[0020] FIG. 5 is FIG. 4 is an enlarged view of a nodal ring of the bending section in the region R shown.

[0021] FIG. 6 is a cross-sectional view of the bending section taken along the C1-C1 line of FIG. 4 and FIG. 5

[0022] FIG. 7 FIG. 4 ​​is a cross-sectional view of the curved portion (second curved portion) of the C2-C2 line cut of the endoscope.

[0023] FIG. 8 is a perspective view of a joint portion of the endoscope.

[0024] FIG. 9 is a perspective view of a part of the joint portion.

[0025] FIG. 10 is a cross-sectional view of the joint portion.

[0026] FIG. 11 is a perspective view of a cylindrical member and a bearing portion of the joint portion.

[0027] FIG. 12 is a view showing a first attachment / detachment portion before attachment to a driving device of the electric endoscope system.

[0028] FIG. 13 is a view showing a first up-and-down curved line attachment / detachment portion before attachment to the driving device.

[0029] FIG. 14 is a view showing the first up-and-down curved line attachment / detachment portion attached to the driving device.

[0030] FIG. 15 is a functional block diagram of a driving device of the electric endoscope system.

[0031] FIG. 16 is a view showing a first up-and-down curved line driving portion to which the first up-and-down curved line attachment / detachment portion is attached.

[0032] FIG. 17 is a perspective view of an operation device of the electric endoscope system.

[0033] FIG. 18 is a perspective view of the operation device as viewed from the back.

[0034] FIG. 19 is a side view of the operation device.

[0035] FIG. 20 is a perspective view of the operation device to which a second forceps port fixing tool is attached.

[0036] FIG. 21 is a functional block diagram of a control device of the electric endoscope system.

[0037] FIG. 22 is a functional block diagram of a main controller of the control device.

[0038] FIG. 23 is a perspective view of a modified example of the operation device.

[0039] FIG. 24is a perspective view of the operating device with the second forceps opening fixing device installed at different positions.

[0040] FIG. 25 is a view showing FIG. 24 is a view showing an example of use of the operating device.

[0041] FIG. 26 is a whole view of an electric endoscope system of a second embodiment.

[0042] FIG. 27 is a functional block diagram of a driving device of the electric endoscope system.

[0043] FIG. 28 is a migration view of a bending mode of a bending section in the electric endoscope system.

[0044] FIG. 29 is a view showing a switching switch of an operating device in the electric endoscope system.

[0045] FIG. 30 is a view showing the bending section controlled in a coordinated bending control mode.

[0046] FIG. 31 is a whole view of an electric endoscope system of a third embodiment.

[0047] FIG. 32 is a view showing a first attachment / detachment section before assembly to a driving device of the electric endoscope system.

[0048] FIG. 33 is a view showing a first up-and-down bending line attachment / detachment section before assembly to the driving device.

[0049] FIG. 34 is a view showing the first up-and-down bending line attachment / detachment section assembled to the driving device.

[0050] FIG. 35 is a functional block diagram of the driving device.

[0051] FIG. 36 is a view showing a first up-and-down bending line driving section assembled with the first up-and-down bending line attachment / detachment section.

[0052] FIG. 37 is a view showing an example of use of a bending section in the electric endoscope system.

[0053] FIG. 38 is a whole view of an electric endoscope system of a fourth embodiment.

[0054] FIG. 39 is a perspective view of a cylindrical member and a bearing section in the electric endoscope system.

[0055] FIG. 40 is an exploded perspective view of the cylindrical member and the bearing portion.

[0056] FIG. 41 is a diagram showing treatment using the electric endoscope system.

[0057] FIG. 42 is a diagram showing a modification example of the joint portion of the electric endoscope system.

[0058] FIG. 43 is a diagram showing the electric endoscope system of the fifth embodiment.

[0059] FIG. 44 is a cross-sectional view of the in-vivo flexible portion of the electric endoscope system.

[0060] FIG. 45 is a cross-sectional view of the in-vivo flexible portion of the electric endoscope system.

[0061] FIG. 46 is a diagram showing two fixed wire sheaths.

[0062] FIG. 47 is a cross-sectional view of the in-vivo flexible portion and the in-vivo flexible portion of the electric endoscope system.

[0063] FIG. 48 is a diagram showing the insertion portion of the electric endoscope system inserted into the large intestine.

[0064] FIG. 49 is a diagram showing the electric endoscope system of the sixth embodiment.

[0065] FIG. 50 is a flowchart showing steps of a process for charging in the electric endoscope system.

[0066] FIG. 51 is a flowchart showing steps of a process for charging in the electric endoscope system.

[0067] FIG. 52 is a diagram showing the electric endoscope system of the seventh embodiment.

[0068] FIG. 53 is a flowchart showing steps of a process for displaying a three-dimensional image in the electric endoscope system.

[0069] FIG. 54 is a diagram showing a positional relationship between an endoscope and a display device in the electric endoscope system.

[0070] FIG. 55 is a diagram showing a positional relationship between an endoscope and a display device in the electric endoscope system.

[0071] FIG. 56 is a view showing an example of a three-dimensional image displayed by the display device in the motor-driven endoscope system.

[0072] FIG. 57 is a view showing an example of a three-dimensional image displayed by the display device in the motor-driven endoscope system.

[0073] FIG. 58 is a view showing a positional relationship among the surgeon, the endoscope, and the display device in the motor-driven endoscope system.

[0074] FIG. 59 is a view showing a positional relationship among the surgeon, the endoscope, and the display device in the motor-driven endoscope system.

[0075] FIG. 60 is a view showing a positional relationship among the surgeon, the endoscope, and the display device in the motor-driven endoscope system.

[0076] FIG. 61 is a view showing a relationship between the first direction and the second direction in the motor-driven endoscope system.

[0077] FIG. 62 is a view showing a relationship between the first direction and the second direction in the motor-driven endoscope system.

[0078] FIG. 63 is a view showing a relationship between the first direction and the second direction in the motor-driven endoscope system.

[0079] FIG. 64 is a view showing an example of an image displayed by the display device in the motor-driven endoscope system.

[0080] FIG. 65 is a view showing an example of an image displayed by the display device in the motor-driven endoscope system.

[0081] FIG. 66 is a view showing an example of an image displayed by the display device in the motor-driven endoscope system.

[0082] FIG. 67 is a view showing an example of an image displayed by the display device in the motor-driven endoscope system.

[0083] FIG. 68 is a view showing an example of an image displayed by the display device in the motor-driven endoscope system.

[0084] FIG. 69 is a view showing an example of an image displayed by the display device in the motor-driven endoscope system.

[0085] FIG. 70 is a view showing an example of an image displayed by the display device in the motor-driven endoscope system.

[0086] FIG. 71 is a whole view of an electric endoscope system of a ninth embodiment.

[0087] FIG. 72 is a functional block diagram of a driving device of the electric endoscope system.

[0088] FIG. 73 is a graph showing a restoring force acting on a bending portion that is bent in the electric endoscope system.

[0089] FIG. 74 is a graph showing another frictional force acting on the bending portion that is bent in the electric endoscope system.

[0090] FIG. 75 is a graph showing a relationship between a bending angle of the bending portion and the restoring force in the electric endoscope system.

[0091] FIG. 76 is a control flowchart of a control device of the electric endoscope system.

[0092] FIG. 77 is a whole view of an electric endoscope system of a tenth embodiment.

[0093] FIG. 78 is a perspective view of an operating device of the electric endoscope system.

[0094] FIG. 79 is a side view of the operating device in which a touch panel is set to a first mode.

[0095] FIG. 80 is a side view of the operating device in which the touch panel is set to a second mode.

[0096] FIG. 81 is a whole view of an electric endoscope system of an eleventh embodiment.

[0097] FIG. 82 is a perspective view of an operating device of the electric endoscope system.

[0098] FIG. 83 is a whole view of an electric endoscope system of a twelfth embodiment.

[0099] FIG. 84 is a perspective view of the operating device viewed from a back surface.

[0100] FIG. 85 is a perspective view of the operating device mounted to an extracorporeal flexible portion.

[0101] FIG. 86 is a graph explaining a method of using the electric endoscope system.

[0102] FIG. 87 Fig. 1 is a diagram showing a modification of the operation apparatus. DETAILED DESCRIPTION

[0103] (First Embodiment)

[0104] Reference FIGS. 1-25 An electric endoscope system 1000 according to a first embodiment of the present application will be described. FIG. 1 Fig. 1 is a diagram showing a modification of the operation apparatus.

[0105] [Electric Endoscope System 1000]

[0106] As shown in Fig. 1, the electric endoscope system 1000 is a medical system that performs observation and treatment of a patient P who is lying on his or her back on an operating table T. The electric endoscope system 1000 is provided with an endoscope 100, a drive device 200, an operation apparatus 300, a treatment instrument 400, an image control device 500, and a display device 900. FIG. 1 The endoscope 100 is a device that is inserted into a lumen of the patient P and performs observation and treatment of a lesion. The endoscope 100 is detachably attached to the drive device 200. An internal path 101 is formed inside the endoscope 100. In the following description, in the endoscope 100, the side to be inserted into the lumen of the patient P is referred to as "distal end side (Al)", and the side to be attached to the drive device 200 is referred to as "proximal end side (A2)".

[0107] The drive device 200 is detachably connected to the endoscope 100 and the operation apparatus 300. The drive device 200 electrically drives the endoscope 100 by driving a motor built therein based on an operation input to the operation apparatus 300. Further, the drive device 200 causes the endoscope 100 to perform air supply and suction by driving a pump or the like built therein based on an operation input to the operation apparatus 300.

[0108] The operation apparatus 300 is detachably connected to the drive device 200 via an operation cable 301. The operation apparatus 300 can communicate with the drive device 200 by wireless communication instead of wired communication. The surgeon S can electrically drive the endoscope 100 by operating the operation apparatus 300.

[0109] The treatment instrument 400 is a device that is inserted into the internal path 101 of the endoscope 100 and into the lumen of the patient P to perform treatment of a lesion. In the following description, in the treatment instrument 400, the side to be inserted into the internal path 101 of the endoscope 100 is referred to as "distal end side (Bl)", and the side to be attached to the endoscope 100 is referred to as "proximal end side (B2)".

[0110] FIG. 1 ​In this case, 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 can also be inserted into the internal path 101 of the endoscope 100 directly from the forceps port 126 without passing through the extension channel tube 130.

[0111] The video control device 500 is detachably connected to the endoscope 100, and acquires the captured image from the endoscope 100. The video control device 500 displays the captured image acquired from the endoscope 100, a GUI image for the purpose of providing information to the operator, and a CG image on the display device 900.

[0112] The driving device 200 and the video control device 500 constitute a control device 600 that controls the electric endoscope system 1000. The control device 600 can also be provided with a peripheral device such as a video printer. The driving device 200 and the video control device 500 can also be an integrated device.

[0113] The control device 600 can be connected to a hospital network, and can acquire information such as an electronic medical record from a server. In addition, the control device 600 can also be connected to the Internet, and can perform maintenance of the endoscope 100 and the like via the Internet.

[0114] The display device 900 is a device that can display an image such as an LCD. The display device 900 is connected to the video control device 500 via a display cable 901.

[0115] FIG. 2 is a view showing the endoscope 100 and the operation device 300 used by the surgeon S.

[0116] The surgeon S, for example, observes the captured image displayed on the display device 900 with the right hand R, operates the endoscope 100 inserted into the lumen from the anus of the patient P, and operates the operation device 300 with the left hand L. Since the endoscope 100 and the operation device 300 are separated, the surgeon S can independently operate them without affecting each other.

[0117] [Endoscope 100]

[0118] As shown in FIG. 1 , the endoscope 100 is provided with an insertion portion 110, a connection portion 120, an extracorporeal flexible portion 140, a detachable portion 150, a bending wire 160 (see FIG. 6 ), and an internal object 170 (see FIG. 6 ). The insertion portion 110, the connection portion 120, the extracorporeal flexible portion 140, and the detachable portion 150 are connected in this order from the distal end side. The connection portion 120 can be connected to the extension channel tube 130.

[0119] FIG. 3 is a view showing the insertion section 110 of the endoscope 100.

[0120] Inside the endoscope 100, an internal path 101 extending from the front end of the insertion section 110 to the base end of the attachment / detachment section 150 along the length direction A of the endoscope 100 is formed. The bending wire 160 and the built-in object 170 are inserted into the internal path 101.

[0121] The built-in object 170 has a channel tube 171, a gas supply / suction tube 172 (refer to FIG. 10 ), an image pickup cable 173, and a light guide 174.

[0122] [Insertion section 110]

[0123] The insertion section 110 is an elongated long member capable of being inserted into a lumen. The insertion section 110 has a front end section 111, a bending section 112, and an in-vivo soft section 119. The front end section 111, the bending section 112, and the in-vivo soft section 119 are connected in this order from the front end side.

[0124] As shown in FIG. 3 , the front end section 111 has an opening section 111a, an illumination section 111b, and an image pickup section 111c. The opening section 111a is an opening communicating with the channel tube 171. As shown in FIG. 3 , a treatment section 410 such as a holding forceps provided at the front end of a treatment instrument 400 that penetrates the channel tube 171 is protruded and retracted from the opening section 111a.

[0125] The illumination section 111b is connected with the light guide 174 that guides illumination light, and emits the illumination light that illuminates an image pickup object. The image pickup section 111c has an image pickup element such as a CMOS, and is used for photographing the image pickup object. An image pickup signal is sent to the image control device 500 via the image pickup cable 173.

[0126] FIG. 4 is a view showing a part of the bending section 112 as a cross-sectional view.

[0127] The bending section 112 has a first bending section 113 of the front end side of the bending section 112, a second bending section 114 of the base end side of the bending section 112, and a sheath 118 (refer to FIG. 3 ). The first bending section 113 and the second bending section 114 are capable of being bent in different directions.

[0128] The first bending section (front end side bending section) 113 has a plurality of joint rings (also referred to as bending blocks) 115 and a first front end section 116 connected with the front ends of the plurality of joint rings 115. The plurality of joint rings 115 and the first front end section 116 are connected in the length direction A inside the sheath 118. In addition, the shape and the number of the joint rings 115 that the first bending section 113 has are not limited to FIG. 4The shape and number of the link rings 115 shown.

[0129] FIG. 5 is FIG. 4 An enlarged view of the link rings 115 in the area R shown.

[0130] The link rings 115 are short cylindrical members formed of metal. The plurality of link rings 115 are joined in a manner such that the inner spaces of the adjacent link rings 115 become a continuous space.

[0131] The link rings 115 have a first link ring 115a on the front end side and a second link ring 115b on the base end side. The first link ring 115a and the second link ring 115b are joined by a first rotation pin 115q in a manner such that they can rotate about a rotation axis extending in an up-down direction (also referred to as a "UD direction") perpendicular to the length direction A.

[0132] In the adjacent link rings 115, the second link ring 115b in the link ring 115 on the front end side and the first link ring 115a in the link ring 115 on the base end side are joined by a second rotation pin 115p in a manner such that they can rotate about a rotation axis extending in a left-right direction (also referred to as a "LR direction") perpendicular to the length direction A and the UD direction.

[0133] The first link ring 115a and the second link ring 115b are alternately joined by the first rotation pin 115q and the second rotation pin 115p, and the curved portion 112 is freely bendable in a desired direction.

[0134] FIG. 6 is a cross-sectional view of the curved portion 112 taken along the C1-C1 line of FIG. 4 and FIG. 5

[0135] The upper wire guide portion 115u and the lower wire guide portion 115d are disposed on both sides in the UD direction with the center axis O of the length direction A interposed therebetween on the inner peripheral surface of the second link ring 115b. The left wire guide portion 115l and the right wire guide portion 115r are disposed on both sides in the LR direction with the center axis O of the length direction A interposed therebetween on the inner peripheral surface of the first link ring 115a.

[0136] Through-holes for the insertion of the curved wire 160 are formed in the upper wire guide portion 115u, the lower wire guide portion 115d, the left wire guide portion 115l, and the right wire guide portion 115r along the length direction A.

[0137] ​The second curved portion (proximal end side curved portion) 114 has a plurality of link rings (also referred to as curved blocks) 115 and a second distal end portion 117 connected to the distal ends of the plurality of link rings 115. The plurality of link rings 115 and the second distal end portion 117 are connected in the length direction A inside the sheath 118. The second distal end portion 117 is connected to the link ring 115 of the proximal end of the first curved portion 113. The link ring 115 of the proximal end of the second curved portion 114 is attached to the distal end of the in-vivo soft portion 119.

[0138] The length of the length direction A of the first curved portion 113 is shorter than the length of the length direction A of the second curved portion 114. Therefore, the distal end side of the curved portion 112 can be bent more precisely from the operation. In addition, the shape and the number of the link rings 115 possessed by the second curved portion 114 are not limited to FIG. 4 the shape and the number of the link rings 115 illustrated.

[0139] The curved line 160 is a line that bends the curved portion 112. The curved line 160 has a first curved line 161 that bends the first curved portion 113 and a second curved line 162 that bends the second curved portion 114. The first curved line 161 and the second curved line 162 extend to the attachment / detachment portion 150 through the internal path 101.

[0140] As illustrated in FIG. 4 and FIG. 6 , the first curved line 161 has a first upper curved line 161u, a first lower curved line 161d, a first left curved line 161l, a first right curved line 161r, and four first line sheaths 161s.

[0141] As illustrated in FIG. 4 and FIG. 7 , the first upper curved line 161u, the first lower curved line 161d, the first left curved line 161l, and the first right curved line 161r are respectively inserted through the first line sheaths 161s. The distal end of the first line sheaths 161s is attached to the second distal end portion 117. The first line sheaths 161s extend to the attachment / detachment portion 150.

[0142] The first upper curved line 161u and the first lower curved line 161d are lines that bend the first curved portion 113 in the UD direction. The first upper curved line 161u is inserted through the upper line guide portion 115u. The first lower curved line 161d is inserted through the lower line guide portion 115d.

[0143] As illustrated in FIG. 4 , the distal ends of the first upper curved line 161u and the first lower curved line 161d are fixed to the first distal end portion 116 of the distal end of the first curved portion 113. The distal ends of the first upper curved line 161u and the first lower curved line 161d fixed to the first distal end portion 116 are disposed on both sides in the UD direction with the center axis O of the length direction A therebetween.

[0144] The first left bending line 1611 and the first right bending line 161r are lines that bend the first bending portion 113 in the LR direction. The first left bending line 1611 is inserted through the left line guide portion 1151. The first right bending line 161r is inserted through the right line guide portion 115r.

[0145] As shown in FIG. 4 , the front ends of the first left bending line 1611 and the first right bending line 161r are fixed to the first front end portion 116 of the first bending portion 113. The front ends of the first left bending line 1611 and the first right bending line 161r fixed to the first front end portion 116 are disposed on both sides of the LR direction with the center axis O of the length direction A therebetween.

[0146] By pulling or relaxing the first bending lines 161 (the first upper bending line 161u, the first lower bending line 161d, the first left bending line 1611, and the first right bending line 161r) respectively, the first bending portion 113 is freely bent in a desired direction.

[0147] FIG. 7 is a cross-sectional view of the second bending portion 114 taken along the C2-C2 line. FIG. 4

[0148] As shown in FIG. 4 and FIG. 7 , the second bending lines 162 include a second upper bending line 162u, a second lower bending line 162d, a second left bending line 1621, a second right bending line 162r, and four second line sheaths 162s.

[0149] As shown in FIG. 4 , the second upper bending line 162u, the second lower bending line 162d, the second left bending line 1621, and the second right bending line 162r are inserted through the second line sheaths 162s, respectively. The front ends of the second line sheaths 162s are fitted to the node ring 115 of the base end of the second bending portion 114. The second line sheaths 162s extend to the detachable portion 150.

[0150] The second upper bending line 162u and the second lower bending line 162d are lines that bend the second bending portion 114 in the UD direction. As shown in FIG. 7 , in the second bending portion 114, the second upper bending line 162u is inserted through the upper line guide portion 115u. In addition, in the second bending portion 114, the second lower bending line 162d is inserted through the lower line guide portion 115d.

[0151] As shown in FIG. 4 ​As shown, the front ends of the second upper bending line 162u and the second lower bending line 162d are fixed to the second front end portion 117 of the front end of the second bending portion 114. The front ends of the second upper bending line 162u and the second lower bending line 162d fixed to the second front end portion 117 are arranged on both sides in the UD direction with the center axis O in the longitudinal direction A interposed therebetween.

[0152] The second left bending line 162l and the second right bending line 162r are lines that bend the second bending portion 114 in the LR direction. As shown, FIG. 7 In the second bending portion 114, the second left bending line 162l is inserted through the left line guide portion 115l. In addition, in the second bending portion 114, the second right bending line 162r is inserted through the right line guide portion 115r.

[0153] As shown, FIG. 4 The front ends of the second left bending line 162l and the second right bending line 162r are fixed to the second front end portion 117 of the front end of the second bending portion 114. The front ends of the second left bending line 162l and the second right bending line 162r fixed to the second front end portion 117 are arranged on both sides in the LR direction with the center axis O in the longitudinal direction A interposed therebetween.

[0154] By pulling or relaxing the second bending lines 162 (the second upper bending line 162u, the second lower bending line 162d, the second left bending line 162l, and the second right bending line 162r) respectively, the second bending portion 114 is freely bent in a desired direction.

[0155] As shown, FIG. 6 and FIG. 7 In the internal path 101 formed inside the bending portion 112, the bending line 160, the channel tube 171, the imaging cable 173, and the light guide 174 are inserted through.

[0156] The in-vivo soft portion 119 is a long and flexible tubular member. In the internal path 101 formed inside the in-vivo soft portion 119, the bending line 160, the channel tube 171, the imaging cable 173, and the light guide 174 are inserted through.

[0157] [Linking portion 120]

[0158] FIG. 8 is a perspective view of the linking portion 120. FIG. 9 is a perspective view of a part of the linking portion 120. FIG. 10 is a cross-sectional view of the linking portion 120.

[0159] The connecting portion 120 is a member that connects the in-vivo soft portion 119 of the insertion portion 110 and the in-vivo soft portion 140. The connecting portion 120 has a cylindrical member 121, a connecting portion main body 122, a seal portion 123, a bearing portion 124, a cover member 125, a forceps port 126, and a trifurcated branch tube 127.

[0160] The cylindrical member 121 is formed in a cylindrical shape. As shown in FIG. 10 , an inner space of the cylindrical member 121 communicates with an inner space of the in-vivo soft portion 119, forming a part of the internal path 101. In the inner space of the cylindrical member 121, the curved line 160, the channel tube 171, the camera cable 173, and the light guide 174 are inserted through. On an outer peripheral surface of the cylindrical member 121, a magnetic ring 121s is installed along the circumferential direction.

[0161] The connecting portion main body 122 is formed in a substantially cylindrical shape. As shown in FIG. 10 , the connecting portion main body 122 has a front end portion 122a and a base end portion 122b. The base end portion 122b of the cylindrical member 121 is inserted into a front end opening of the front end portion 122a. On the base end portion 122b, the front end portion 140a of the in-vivo soft portion 140 is joined by an adhesive or heat fusion, or the like. An inner space of the connecting portion main body 122 communicates with an inner space of the in-vivo soft portion 140, forming a part of the internal path 101.

[0162] The seal portion 123 has 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.

[0163] FIG. 11 is a perspective view of the cylindrical member 121 and the bearing portion 124.

[0164] The bearing portion 124 links the connecting portion main body 122 and the cylindrical member 121 so as to be rotatable about a rotation axis extending along the length direction A. Specifically, the bearing portion 124 is fixed to the connecting portion main body 122. The bearing portion 124 supports the cylindrical member 121 so as to be rotatable about a rotation axis extending along the length direction A.

[0165] The connecting portion main body 122 has a not-shown magnetic sensor that detects the rotation of the magnetic ring 121s, and can detect the rotation angle of the cylindrical member 121 with respect to the connecting portion main body 122. The detected rotation angle is transmitted to the control device 600 via a not-shown transmission cable.

[0166] The proximal end portion 119b of the intracorporeal flexible portion 119 is fixed to the outside of the housing 123h. Thus, the intracorporeal flexible portion 119, the housing 123h, and the cylindrical member 121 are integrated and rotate with respect to the coupling portion main body 122.

[0167] The cover member 125 is a member that covers the outer periphery of the coupling portion main body 122. The cover member 125 has a first opening 125b through which the extracorporeal flexible portion 140 passes and a second opening 125c through which the forceps port 126 passes. The gap between the first opening 125b and the extracorporeal flexible portion 140 is closed by a seal member. The gap between the second opening 125c and the forceps port 126 is closed by a seal member.

[0168] The forceps port 126 is an insertion port for inserting the treatment instrument 400. The forceps port 126 is formed in a cylindrical shape and is attached to the cover member 125. The proximal end portion 126b of the forceps port 126 protrudes from the second opening 125c of the cover member 125. The proximal end portion 126b of the forceps port 126 can be connected to the extension channel tube 130 (refer to FIG. 1 ).

[0169] The trident branch tube 127 connects the proximal end portion 171b of the channel tube 171, the distal end portion 126a of the forceps port 126, and the distal end portion 172a of the gas supply and suction tube 172. The channel tube 171 and the gas supply and suction tube 172 are connected via the trident branch tube 127. Further, the forceps port 126 and the channel tube 171 are connected via the trident branch tube 127. The surgeon S can insert the treatment instrument 400 from the proximal end portion 126b of the forceps port 126 so that the treatment instrument 400 is inserted through the channel tube 171.

[0170] The intracorporeal flexible portion 119 and the extracorporeal flexible portion 140 are coupled by the coupling portion 120 so as to be rotatable about a rotation axis extending in the longitudinal direction A. Thus, as shown in FIG. 2 , in a case where the surgeon S rotates the intracorporeal flexible portion 119 of the insertion portion 110 about the rotation axis extending in the longitudinal direction A, the extracorporeal flexible portion 140 extending to the vicinity of the drive device 200 can be rotated without rotating the intracorporeal flexible portion 119. Thus, the surgeon S can easily perform a rotation operation on the intracorporeal flexible portion 119.

[0171] On the other hand, friction is generated when the internal soft part 119 and the external soft part 140 rotate relative to each other, so they will not rotate relative to each other unless a specified force is applied. This friction is adjusted so that the internal soft part 119 will not rotate relative to the external soft part 140 unless the surgeon S rotates it. Therefore, even if the surgeon S removes his right hand R from the internal soft part 119 to operate the treatment instrument 400, the internal soft part 119 will not rotate relative to the external soft part 140.

[0172] Furthermore, when the surgeon S rotates the internal soft part 119 of the insertion part 110 around a rotation axis extending along the length direction A, the forceps jaw 126, which rotates in conjunction with the internal soft part 119, i.e., the part installed on the connecting body 122, does not rotate. Since the position of the forceps jaw 126 for inserting the treatment instrument 400 does not change, the surgeon S can easily operate the treatment instrument 400.

[0173] The base end portion 121b of the cylindrical member 121 is inserted inside the connecting body 122. Therefore, the bending line 160, etc., that penetrates the cylindrical member 121 and the connecting body 122 mainly passes through the internal space of the cylindrical member 121, making it difficult for it to come into contact with the connecting body 122, which rotates relative to the cylindrical member 121. Therefore, even if the cylindrical member 121 and the connecting body 122 rotate relative to each other, the bending line 160, etc., is not easily twisted.

[0174] [External soft tissue 140]

[0175] The external flexible part 140 is an elongated tubular component. A curved wire 160, a camera cable 173, a light guide 174, and an air delivery / suction tube 172 (see reference) are inserted through the internal path 101 formed within the external flexible part 140. FIG. 10 ).

[0176] [Loading and Unloading Section 150]

[0177] like FIG. 1 As shown, the loading / unloading unit 150 includes a first loading / unloading unit 1501 mounted on the drive unit 200 and a second loading / unloading unit 1502 mounted on the image control unit 500. Alternatively, the first loading / unloading unit 1501 and the second loading / unloading unit 1502 may be an integral loading / unloading unit.

[0178] An internal path 101 formed inside the external flexible part 140 branches into a first loading / unloading part 1501 and a second loading / unloading part 1502. A curved wire 160 and an air supply suction tube 172 are inserted through the first loading / unloading part 1501. A camera cable 173 and an optical guide 174 are inserted through the second loading / unloading part 1502.

[0179] FIG. 12 Fig. 1 is a view showing the first attachment / detachment portion 1501 before being assembled to the driving device 200.

[0180] The first attachment / detachment portion 1501 has a first upper and lower curved line attachment / detachment portion 151, a first left and right curved line attachment / detachment portion 152, a second upper and lower curved line attachment / detachment portion 153, and a second left and right curved line attachment / detachment portion 154.

[0181] The first upper and lower curved line attachment / detachment portion 151 is a mechanism that attachment / detachably links lines (a first upper curved line 161u and a first lower curved line 161d) that curve the first curved portion 113 in the UD direction to the driving device 200.

[0182] The first left and right curved line attachment / detachment portion 152 is a mechanism that attachment / detachably links lines (a first left curved line 1611 and a first right curved line 161r) that curve the first curved portion 113 in the LR direction to the driving device 200.

[0183] The second upper and lower curved line attachment / detachment portion 153 is a mechanism that attachment / detachably links lines (a second upper curved line 162u and a second lower curved line 162d) that curve the second curved portion 114 in the UD direction to the driving device 200.

[0184] The second left and right curved line attachment / detachment portion 154 is a mechanism that attachment / detachably links lines (a second left curved line 1621 and a second right curved line 162r) that curve the second curved portion 114 in the LR direction to the driving device 200.

[0185] The first left and right curved line attachment / detachment portion 152, the second upper and lower curved line attachment / detachment portion 153, and the second left and right curved line attachment / detachment portion 154 are the same configuration as the first upper and lower curved line attachment / detachment portion 151, and thus, the illustration and explanation are omitted.

[0186] FIG. 13 Fig. 2 is a view showing the first upper and lower curved line attachment / detachment portion 151 before being assembled to the driving device 200. FIG. 14 Fig. 3 is a view showing the first upper and lower curved line attachment / detachment portion 151 assembled to the driving device 200. The first upper and lower curved line attachment / detachment portion 151 has a support member 155, a rotating drum 156, and a tension sensor 159.

[0187] The support member 155 supports the rotating drum 156. The support member 155 has an attachment / detachment detection protrusion 155a that protrudes on the base end side of the first upper and lower curved line attachment / detachment portion 151, and a plurality of deflection rollers 155p.

[0188] The deflection wheel 155p changes the transport direction of the first upper curved line 161u that is inserted through the extracorporeal soft portion 140, and guides the first upper curved line 161u to the rotating drum 156. Further, the deflection wheel 155p changes the transport direction of the first lower curved line 161d that is inserted through the extracorporeal soft portion 140, and guides the first lower curved line 161d to the rotating drum 156.

[0189] The rotating drum 156 is supported to the support member 155 in a manner that is rotatable about a drum rotation axis 156r that extends in the length direction A. The rotating drum 156 has a winding wheel 156a and a coupling portion 156c.

[0190] The winding wheel 156a pulls or feeds the first upper curved line 161u and the first lower curved line 161d by rotating about the drum rotation axis 156r. When the winding wheel 156a is rotated clockwise as viewed from the front end side toward the base end side, the first upper curved line 161u is pulled by being wound on the winding wheel 156a, and the first lower curved line 161d is fed from the winding wheel 156a. Conversely, when the winding wheel 156a is rotated counterclockwise, the first upper curved line 161u is fed from the winding wheel 156a, and the first lower curved line 161d is pulled by being wound on the winding wheel 156a.

[0191] The portions of the first upper curved line 161u and the first lower curved line 161d that are wound on the winding wheel 156a have a diameter that is thicker than the other portions. Therefore, the first upper curved line 161u and the first lower curved line 161d can be appropriately prevented from being pinched between the winding wheel 156a and the support member 155. Further, elongation that accompanies pulling or slackening of the first upper curved line 161u and the first lower curved line 161d can be appropriately prevented.

[0192] The coupling portion 156c is a circular plate member that rotates about the drum 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 on the base end side of the first upper and lower curved line attachment / detachment portion 151. Two fitting protrusions 156d are formed on the face on the base end side of the coupling portion 156c. The two fitting protrusions 156d are formed on both sides with the drum rotation axis 156r interposed therebetween.

[0193] The tension sensor 159 detects the tension of the first upper curved line 161u and the first lower curved line 161d. The detection result of the tension sensor 159 is acquired by the drive controller 260.

[0194] [Drive device 200]

[0195] FIG. 15 is a functional block diagram of the drive device 200.

[0196] The driving device 200 includes an adapter 210, an operation receiving section 220, a gas / suction driving section 230, a wire driving section 250, and a driving controller 260.

[0197] As shown in FIG. 1, the adapter 210 has a first adapter 211 and a second adapter 212. The first adapter 211 is an adapter that is detachably connected to the operation cable 301. The second adapter 212 is an adapter that is detachably connected to the first detachable section 1501 of the endoscope 100. FIG. 12 The operation receiving section 220 receives an operation input from the operation device 300 via the operation cable 301. In a case where the operation device 300 and the driving device 200 communicate by wireless communication, not by wired communication, the operation receiving section 220 has a publicly known wireless reception module.

[0198] The gas / suction driving section 230 is connected to the gas / suction tube 172 inserted into the internal path 101 of the endoscope 100. The gas / suction driving section 230 has a pump or the like, and supplies gas to the gas / suction tube 172. In addition, the gas / suction driving section 230 sucks air from the gas / suction tube 172.

[0199] The wire driving section 250 is coupled to the first up / down bending wire detachable section 151, the first left / right bending wire detachable section 152, the second up / down bending wire detachable section 153, and the second left / right bending wire detachable section 154, and drives the bending wire 160.

[0200] As shown in FIG. 1, the wire driving section 250 has a first up / down bending wire driving section 251, a first left / right bending wire driving section 252, a second up / down bending wire driving section 253, and a second left / right bending wire driving section 254.

[0201] FIG. 12 The first up / down bending wire driving section 251 is a mechanism that is coupled to the first up / down bending wire detachable section 151, and drives 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.

[0202] The first left / right bending wire driving section 252 is a mechanism that is coupled to the first left / right bending wire detachable section 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.

[0203] The second up / down bending wire driving section 253 is a mechanism that is coupled to the second up / down bending wire detachable section 153, and drives 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.

[0204] The second left / right bending wire driving section 254 is a mechanism that is coupled to the second left / right bending wire detachable section 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. ​

[0205] The second left and right bending wire driving section 254 is a mechanism that drives the wires (the second left bending wire 1621 and the second right bending wire 162r) that bend the second bending section 114 in the LR direction in conjunction with the second left and right bending wire attachment and detachment section 154.

[0206] The first left and right bending wire driving section 252, the second up and down bending wire driving section 253, and the second left and right bending wire driving section 254 are of the same configuration as the first up and down bending wire driving section 251, and thus, the illustration and description thereof are omitted.

[0207] As shown in FIG. 6, the first up and down bending wire driving section 251 has a support member 255, a bending wire driving section 256A, an engagement member 258, and an attachment and detachment sensor 259. FIG. 13 The bending wire driving section 256A is coupled to the rotating drum 156 of the first up and down bending wire attachment and detachment section 151 to drive the first upper bending wire 161u and the first lower bending wire 161d. The bending wire driving section 256A has a shaft 256a, a motor section 256b, a coupled section 256c, a torque sensor 256e, a fitting detection sensor 256f, and an elastic member 256s.

[0208] The shaft 256a is supported to the support member 255 in a manner that it can rotate around the shaft rotation axis 256r and can advance and retreat in the length direction A. When the first attachment and detachment section 1501 of the endoscope 100 is fitted to the driving device 200, the shaft rotation axis 256r coincides with the drum rotation axis 156r.

[0209] The motor section 256b has a motor such as a DC motor, a motor driver that drives the motor, and a motor encoder. The motor rotates the shaft 256a around the shaft rotation axis 256r. The motor driver is controlled by the driving controller 260.

[0210] The coupled section 256c is a circular plate member that rotates around the shaft rotation axis 256r. The coupled section 256c is fixed to the front end of the shaft 256a and rotates integrally with the shaft 256a. As shown in FIG. 6, the coupled section 256c is exposed on the front end side of the first up and down bending wire driving section 251. Two fitting recesses 256d are formed on the face on the front end side of the coupled section 256c. The two fitting recesses 256d are formed on both sides across the shaft rotation axis 256r.

[0211] FIG. 13

[0212] As shown in FIG. 6, the first up and down bending wire driving section 251 has a support member 255, a bending wire driving section 256A, an engagement member 258, and an attachment and detachment sensor 259. FIG. 14 ​​As shown, the fitting protrusion 156d engages with the fitting recess 256d, and the connecting portion 156c connects with the connected portion 256c. As a result, the rotation of the shaft 256a driven by the motor portion 256b is transmitted to the rotating roller 156. When viewed from the front end side towards the base end side, the shaft 256a rotates clockwise, thereby pulling the first upper curved line 161u and sending out the first lower curved line 161d. Conversely, by rotating the first shaft 256a counterclockwise, the first upper curved line 161u is sent out, and the first lower curved line 161d is pulled.

[0213] The torque sensor 256e detects the rotational torque of shaft 256a about the shaft rotation axis 256r. The detection result of the torque sensor 256e is obtained by the drive controller 260.

[0214] The mating detection sensor 256f detects the mating of the mating protrusion 156d and the mating recess 256d. For example... FIG. 14 As shown, the connected portion 256c moves towards the base end side (A2) together with the shaft 256a by being pressed in by the connected portion 156c. The engagement detection sensor 256f detects the engagement of the engagement protrusion 156d and the engagement recess 256d by detecting the approach of the engagement detection protrusion 256g provided on the shaft 256a. The detection result of the engagement detection sensor 256f is obtained by the drive controller 260.

[0215] The elastic member 256s is, for example, a compression spring, with its front end in contact with the connected portion 256c and its base end in contact with the supporting member 255. The elastic member 256s applies a force to the connected portion 256c towards its front end (A1). FIG. 13 As shown, when the connecting part 156c is disassembled, the connected part 256c moves together with the shaft 256a toward the front end side (A1). As a result, the engagement detection sensor 256f cannot detect the engagement between the engagement protrusion 156d and the engagement recess 256d.

[0216] like FIG. 14 As shown, the loading / unloading sensor 259 detects the engagement and disengagement of the first vertical curved line loading / unloading section 151 relative to the first vertical curved line drive section 251 by detecting engagement and disengagement with the loading / unloading detection protrusion 155a. The detection result of the loading / unloading sensor 259 is obtained by the drive controller 260.

[0217] FIG. 16 This diagram shows the first vertical bending line drive unit 251 equipped with the first vertical bending line loading and unloading unit 151. FIG. 16 In the process, the loading and unloading sensor 259 detects that the first upper and lower bending line loading and unloading part 151 is assembled onto the first upper and lower bending line drive part 251.

[0218] like FIG. 16As shown, in a case where the coupling portion 156c is in contact with the coupled portion 256c but the fitting convex portion 156d is not fitted with the fitting concave portion 256d, the fitting detection sensor 256f does not detect the fitting of the fitting convex portion 156d with the fitting concave portion 256d. In this case, the drive controller 260 rotates the coupled portion 256c to a position where the fitting concave portion 256d can be fitted with the fitting convex portion 156d. As a result, the coupled portion 256c moves to the proximal end side (A2) by the elastic member 256s, and thus the fitting convex portion 156d is fitted with the fitting concave portion 256d. The fitting detection sensor 256f detects the fitting of the fitting convex portion 156d with the fitting concave portion 256d.

[0219] The drive controller 260 controls the entire drive device 200. The drive controller 260 acquires an operation input received by the operation receiving portion 220. The drive controller 260 controls the air feeding and suction drive portion 230 and the wire drive portion 250 on the basis of the acquired operation input. In addition, the drive controller 260 can also perform other processing such as image processing or image recognition processing.

[0220] The drive controller 260 is a computer that has a processor, a memory, a storage portion capable of storing programs and data, and an input / output control portion. The functions of the drive controller 260 are realized by the processor executing the programs. The functions of at least a part of the drive controller 260 can also be realized by a dedicated logic circuit.

[0221] The drive controller 260 is desirably provided with high arithmetic performance so that the plurality of motors that drive the plurality of bending wires 160 are controlled with high precision.

[0222] In addition, the drive controller 260 can also have a structure other than the processor, the memory, the storage portion, and the input / output control portion. For example, the drive controller 260 can also have an image arithmetic portion that performs a part or all of the image processing or the image recognition processing. By also having the image arithmetic portion, the drive controller 260 can perform a specific image processing or image recognition processing at high speed. The image arithmetic portion can also be mounted on a hardware device that is provided separately and connected by a communication line.

[0223] [Operation device 300]

[0224] FIG. 17 is a perspective view of the operation device 300. FIG. 18 is a perspective view of the operation device 300 as viewed from the back face 311. FIG. 19 is a side view of the operation device 300.

[0225] The operation device 300 is a device into which an operation for driving the endoscope 100 is input. The input operation is transmitted to the drive device 200 via the operation cable 301.

[0226] The operation device 300 is provided with an operation section main body 310, a first angle knob 320, a second angle knob 330, a switching switch 340, an air supply button 350, a suction button 351, and various buttons 352.

[0227] The operation section main body 310 is formed in a substantially cylindrical shape that the surgeon S can hold with the left hand L. As shown in FIG. 1, a back surface 311 that can follow the back of the palm of the left hand L of the surgeon S is formed on the operation section main body 310. An operation cable 301 is connected to the end portion in the length direction of the operation section main body 310. FIG. 18

[0228] The first angle knob 320 and the second angle knob 330 are rotatably attached to the operation section main body 310. The first angle knob 320 and the second angle knob 330 are attached to the front surface 312 on the side opposite to the back surface 311. The first angle knob 320 and the second angle knob 330 rotate about the same rotation axis 300r. The rotation operation input to the first angle knob 320 and the second angle knob 330 is transmitted to the drive device 200.

[0229] 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-rear direction", and the direction in which the first angle knob 320 and the second angle knob 330 are attached to the operation section main body 310 is defined as the "front direction FR". The opposite direction thereof is defined as the "rear direction RR". Further, the length direction of the operation section main body 310 is defined as the "up-down direction", and the direction in which the operation cable 301 is attached to the operation section main body 310 is defined as the "lower direction LWR". The opposite direction thereof is defined as the "upper direction UPR". The direction toward the right direction when facing the rear direction RR is defined as the "right direction RH". The opposite direction thereof is defined as the "left direction LH". The direction toward the right direction RH or the left direction LH is defined as the "left-right direction".

[0230] In the present embodiment, the direction of the rotation axis 300r of the first angle knob 320 and the second angle knob 330 (front-rear direction) is a direction substantially perpendicular to the back surface 311 of the operation section main body 310.

[0231] The switching switch 340 is attached to the upper direction UPR of the operation section main body 310, as shown in FIG. 1. FIG. 18 ​The switch 340 is operated by the thumb of the left hand L as shown. The switch 340 switches the bending mode of the bending portion 112 of the endoscope 100. The switch 340 has a lever switch 341 and a push button switch 342. When the lever switch 341 of the switch 340 is tilted upward UPR, the bending mode becomes "a first bending portion control mode (a distal end side bending portion control mode) Ml". When the lever switch 341 of the switch 340 is tilted downward LWR, the bending mode becomes "a second bending portion control mode (a base end side bending portion control mode) M2". In addition, the bending mode can be selected by the push button switch 342. The selected bending mode is transmitted to the driving device 200.

[0232] The air feeding button 350 is installed on the upper side UPR of the operation portion main body 310, as shown in FIG. 1. FIG. 18 The air feeding button 350 is operated by the index finger or the middle finger of the left hand L as shown. When the air feeding button 350 is pressed, air feeding is performed from the opening portion 111a of the distal end portion 111 of the endoscope 100. The operation of the air feeding button 350 is transmitted to the driving device 200.

[0233] The suction button 351 is installed on the upper side UPR of the operation portion main body 310, as shown in FIG. 1. FIG. 2 The suction button 351 is operated by the index finger or the middle finger of the left hand L as shown. When the suction button 351 is pressed, suction is performed from the opening portion 111a of the distal end portion 111 of the endoscope 100. The operation of the suction button 351 is transmitted to the driving device 200.

[0234] The driving controller 260 of the driving device 200 acquires the operation input transmitted by the operation device 300, and controls the air feeding and suction driving portion 230 and the wire driving portion 250.

[0235] When the bending mode is the first bending portion control mode Ml, the driving controller 260 drives 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, based on the rotation operation of the first angle knob 320, by controlling the first upper and lower bending wire driving portion 251. In addition, the driving controller 260 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, based on the rotation operation of the second angle knob 330, by controlling the first left and right bending wire driving portion 252.

[0236] 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 portions 253 to drive the wires (the second upper bending wire 162u and the second lower bending wire 162d) that cause the second bending portion 114 to bend in the UD direction, based on the rotation operation of the first angle knob 320. Further, the drive controller 260 controls the second left and right bending wire drive portions 254 to drive the wires (the second left bending wire 162l and the second right bending wire 162r) that cause the second bending portion 114 to bend in the LR direction, based on the rotation operation of the second angle knob 330.

[0237] When the lever switch 341 is tilted upward UPR, the bending mode becomes the "first bending portion control mode Ml" in which the first bending portion 113 at the front end side is bent. On the other hand, when the lever switch 341 is tilted downward LWR, the bending mode becomes the "second bending portion control mode M2" in which the second bending portion 114 at the base end side is bent. Therefore, the surgeon S can intuitively switch the bending mode.

[0238] The operation device 300 does not have a drive mechanism that drives the bending portion 112 of the endoscope 100, and thus is small and light. Further, the first angle knob 320, the second angle knob 330, the air feeding button 350, the suction button 351, and the various buttons 352 are arranged at positions at which the surgeon S can sufficiently operate them with only the left hand L. Therefore, as shown in FIG. 1, the surgeon S can easily hold and operate the operation device 300 with only the left hand L. FIG. 20

[0239] FIG. 20 FIG. 10 is an external view of the operation device 300 to which the second forceps port fixing device 360 is attached.

[0240] The second forceps port fixing device 360 can be attached to the operation device 300. The second forceps port fixing device 360 is attached to the operation device 300 by an adhesive sheet, a magnet, or the like. The second forceps port fixing device 360 has a second forceps port 361 that is formed in a substantially cylindrical shape.

[0241] The second forceps port 361 has a first opening 362 and a second opening 363 that communicate with the internal space. The second opening 363 is connected to the extension channel tube 130. The second opening 363 can be connected to the forceps port 126 of the joint portion 120 via the extension channel tube 130. The surgeon S can insert the treatment instrument 400 from the first opening 362 of the second forceps port 361, and insert the treatment instrument 400 through the extension channel tube 130 and the forceps port 126 into the channel tube 171.

[0242] FIG. 21 ​The second forceps port fixing instrument 360 is installed at a position equivalent to the forceps port in the operation section of the conventional flexible endoscope. Therefore, the surgeon S can operate the operation device 300 and the treatment instrument 400 by the same operation sense as the operation section of the conventional flexible endoscope.

[0243] The second forceps port fixing instrument 360 can also be installed at any place of the operation device 300. The second forceps port fixing instrument 360 is installed at a position where the surgeon S can easily operate the treatment instrument 400. Two or more second forceps port fixing instruments 360 can also be installed to the operation device 300.

[0244] [Image control device 500]

[0245] FIG. 22 is a functional block diagram of the image control device 500.

[0246] The image control device 500 controls the motor-driven endoscope system 1000. The image control device 500 includes a third adapter 510, an image pickup processing section 520, a light source section 530, and a main controller 560.

[0247] The third adapter 510 is an adapter that is detachably connected to the second attachment / detachment section 1502 of the endoscope 100.

[0248] The image pickup processing section 520 converts an image pickup signal acquired from the image pickup section 111c of the distal end section 111 via the image pickup cable 173 into an image pickup image.

[0249] The light source section 530 generates illumination light to be irradiated to an image pickup object. The illumination light generated by the light source section 530 is guided to the illumination section 111b of the distal end section 111 via the light guide 174.

[0250] FIG. 22 is a functional block diagram of the main controller 560.

[0251] The main controller 560 is a computer including a processor 561 and a storage 562 that can execute a program. The functions of the main controller 560 are realized by the processor 561 executing the program. At least a part of the functions of the main controller 560 can also be realized by a dedicated logic circuit.

[0252] The main controller 560 includes the processor 561, the storage 562 that can read in a program, a storage section 563, and an input / output control section 564.

[0253] The storage section 563 is a nonvolatile recording medium that stores the above-mentioned program or required data. The storage section 563 is constituted by, for example, a ROM or a hard disk, or the like. The program recorded in the storage section 563 is read into the storage 562 and executed by the processor 561.

[0254] The input / output control section 564 is connected to the imaging processing section 520, the light source section 530, the driving device 200, the display device 900, an input device (not shown), and a network device (not shown). The input / output control section 564 performs transmission and reception of data and transmission and reception of control signals with respect to the connected devices based on the control of the processor 561.

[0255] The main controller 560 can perform image processing on the captured image acquired by the imaging processing section 520. The main controller 560 can generate a GUI image and a CG image for the purpose of providing information to the surgeon S. The main controller 560 can cause the captured image, the GUI image, and the CG image to be displayed on the display device 900.

[0256] The main controller 560 is connected to an in-hospital network and can acquire information such as an electronic medical record from a server. In addition, the main controller 560 can also be connected to the Internet and can perform maintenance of the endoscope 100 and the like via the Internet.

[0257] The main controller 560 is not limited to being an integrated hardware device. For example, the main controller 560 can also be configured by connecting separate hardware devices via a communication line on the basis of being separated in part as separate hardware devices. For example, the main controller 560 can also be a cloud system in which separate storage sections 563 are connected via a communication line.

[0258] The main controller 560 also has FIG. 23 structures other than the processor 561, the memory 562, the storage section 563, and the input / output control section 564 shown in the drawing. For example, the main controller 560 also has an image operation section that performs part or all of the image processing or the image recognition processing performed by the processor 561. By also having the image operation section, the main controller 560 can perform a specific image processing or image recognition processing at high speed. The image operation section can also be mounted on a separate hardware device connected via a communication line.

[0259] According to the electric endoscope system 1000 of the present embodiment, observation or treatment using the endoscope 100 can be performed more efficiently. Since the endoscope 100 is separated from the operation device 300, the surgeon S can independently operate the endoscope 100 and the operation device 300 without affecting each other.

[0260] In a case where the surgeon S rotates the in-vivo soft portion 119 of the insertion portion 110 about a rotation axis extending in the length direction A, only the in-vivo soft portion 119 can be rotated. Therefore, the surgeon S can easily perform a rotation operation on the in-vivo soft portion 119. On the other hand, as long as the surgeon S does not rotate the in-vivo soft portion 119 of the insertion portion 110, the in-vivo soft portion 119 does not rotate with respect to the out-of-vivo soft portion 140. Therefore, for example, even in a case where the surgeon S moves the right hand R away from the in-vivo soft portion 119 in order to manipulate the treatment instrument 400, the in-vivo soft portion 119 does not rotate with respect to the out-of-vivo soft portion 140.

[0261] The driving mechanism that drives the bending portion 112 is not provided to the operation device 300 but is provided to the driving device 200. Therefore, the operation device 300 can be easily downsized, and the surgeon S can easily manipulate the operation device 300 with one hand.

[0262] The surgeon S switches the bending mode by the switching switch 340, whereby the bending portion 112 having the first bending portion 113 and the second bending portion 114 to bend in two stages (multistage bending function) can be manipulated only by the first angle knob 320 and the second angle knob 330. The operation device 300 can also not separate the angle knob or the like that operates the first bending portion 113 and the angle knob or the like that operates the second bending portion 114. Therefore, the operation device 300 can be easily downsized, and the surgeon S can easily manipulate the operation device 300 with one hand.

[0263] The first embodiment of the present application has been described above with reference to the drawings, but the specific structure is not limited to this embodiment, and design changes or the like within a range not departing from the gist of the present application are also included. Furthermore, the structural elements shown in the above-described embodiments and modified examples can be appropriately combined.

[0264] (Modified Example 1-1)

[0265] In the above-described embodiments, the surgeon S manipulates the endoscope 100 with the right hand R and manipulates the operation device 300 with the left hand L. However, the usage of the power endoscope system 1000 is not limited to this. The surgeon S can manipulate the endoscope 100 with the left hand L and manipulate the operation device 300 with the right hand R. In this case, the operation device 300 is optimized to be easily manipulated with the right hand R.

[0266] (Modified Example 1-2)

[0267] In the above embodiment, the bending portion 112 has the first bending portion 113 and the second bending portion 114 to have a bending function in two stages (a multi-stage bending function). However, the manner of the bending portion 112 is not limited to this. The bending portion 112 can also not have the first bending portion 113 and have only the second bending portion 114. The bending portion 112 can also have a third bending portion to be able to bend in three stages.

[0268] (Modified Example 1-3)

[0269] In the above embodiment, the operation cable 301 is attached to the end portion in the length direction 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 to this. FIG. 24 is a perspective view of an operation device 300A that is a modified example of the operation device 300. The operation device 300A has an operation portion main body 310A, a first angle knob 320, a second angle knob 330, a switching switch 340, a gas feeding button 350, a suction button 351, and various buttons 352.

[0270] The operation portion main body 310A is different from the operation portion main body 310 of the operation device 300 of the above embodiment in the position where the operation cable 301 is connected. The operation portion main body 310A has an operation cable connection portion 313 that connects the operation cable 301.

[0271] The operation cable connection portion 313 is provided above the operation portion main body 310A UPR and in the vicinity of the switching switch 340. The operation cable connection portion 313 extends from the back surface 311 of the operation portion main body 310A to the left direction LH. The operation cable connection portion 313 can also extend from the side surface of the operation portion main body 310A in the left direction LH.

[0272] The operation cable connection portion 313 is provided at a position equivalent to the position where the general cable is connected in the operation portion of the conventional flexible endoscope. Therefore, the surgeon S can stably hold the operation device 300A by pinching the operation cable connection portion 313 with the thumb and the index finger of the left hand L as with the operation portion of the conventional flexible endoscope.

[0273] The operation device 300A can also communicate with the driving device 200 through wireless communication, and the operation cable connection portion 313 to which the operation cable 301 is not connected can be provided in the operation portion main body 310A even if the operation cable 301 is not connected to the operation device 300A. The surgeon S can stably hold the operation device 300A by pinching the operation cable connection portion 313 with the thumb and the index finger of the left hand L.

[0274] (Modified Example 1-4)

[0275] In the above embodiment, the second forceps port fixing device 360 is installed at a position equivalent to the forceps port in the operation section of the conventional flexible endoscope. However, the installation position of the second forceps port fixing device 360 is not limited to this. FIG. 24 is a perspective view of the operation device 300 in which the second forceps port fixing device 360 is installed at a different position. FIG. 24 The second forceps port fixing device 360 illustrated is installed at the back face 311 of the operation section main body 310. FIG. 25 The first opening 362 of the second forceps port fixing device 360 illustrated is disposed in the vicinity of the suction button 351 of the operation section main body 310.

[0276] FIG. 24 is a view illustrating FIGS. 26-30 is a diagram showing an example of use of the operation device 300.

[0277] The surgeon S inserts the treatment instrument 400 from the first opening 362, and makes the treatment instrument 400 penetrate the insertion channel tube 171 via the elongated channel tube 130 and the forceps port 126. The surgeon S can hold the operation device 300 with the left hand L, and hold the treatment instrument 400 inserted from the first opening 362 with the index finger and the middle finger of the left hand L. The surgeon S can perform the advance and retreat operation of the treatment instrument 400 with the index finger and the middle finger of the left hand L while performing the rotation operation of the first angle knob 320 and the second angle knob 330 with the thumb of the left hand L. The surgeon S can also hold the treatment instrument 400 with a finger other than the index finger and the middle finger of the left hand L.

[0278] If the second forceps port fixing device 360 is installed to the operation device 300 in a manner that the treatment instrument 400 is disposed at a position operable with the left hand L, the surgeon S can operate the treatment instrument 400 with the left hand L. Therefore, the surgeon S does not need to move the right hand R from the insertion section 110 of the endoscope 100 in order to operate the treatment instrument 400. The surgeon S can maintain the state of supporting the insertion section 110 of the endoscope 100 with the right hand R while operating the operation device 300 or the treatment instrument 400. The second forceps port fixing device 360 can be installed at an optimum position for the surgeon S in accordance with the size of the left hand L of the surgeon S.

[0279] (Second Embodiment)

[0280] Reference FIG. 26 , an electric endoscope system 1000B according to a second embodiment of the present application will be described. In the following description, the same reference numerals are assigned to structures common to those already described, and repetitive description will be omitted. FIG. 26 is a whole view of the electric endoscope system 1000B according to the present embodiment.

[0281] [Electric Endoscope System 1000B]

[0282] like FIG. 27 As shown, the electric endoscope system 1000B is a medical system for observing and treating the body of a patient P lying horizontally on an operating table T. The electric endoscope system 1000B includes an endoscope 100, a drive unit 200B, an operating unit 300B, a treatment instrument 400, an image control unit 500, and a display unit 900. The drive unit 200B and the image control unit 500 constitute a control unit 600B for controlling the electric endoscope system 1000B.

[0283] [Drive Unit 200B]

[0284] FIG. 28 This is a functional block diagram of the drive unit 200B.

[0285] The drive unit 200B includes an adapter 210, an operation receiver 220, an air delivery and suction drive unit 230, a line drive unit 250, and a drive controller 260B.

[0286] FIG. 26 It is a migration graph of the bending mode.

[0287] 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 (front end side bending portion control mode) M1" and the "second bending portion control mode (base end side bending portion control mode) M2", the drive controller 260B also has a "coordinated control mode M3" that coordinates the control of the first bending portion 113 and the second bending portion 114. The bending modes in the coordinated control mode M3 are further classified into a "simulated single bending control mode M4 (first mode)" where the bending portion 112 bends as a single bending portion, a "coordinated bending control mode M5 (second mode)" where the first bending portion 113 and the second bending portion 114 bend in coordination, and a "simulated single bending transition mode M6 (third mode)".

[0288] When the bending mode is the analog 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 are bent in the same direction with respect to the length direction A. The drive controller 260B processes the bending portion 112 having the first bending portion 113 and the second bending portion 114 and bent in two stages as one bending portion. The bending portion 112 is controlled to be a bending shape (hereinafter referred to as "single-bending shape") of a bending portion in a conventional flexible endoscope that does not have a bending portion to be bent in multiple stages (multi-stage bending function).

[0289] When the bending mode is the coordinated bending control mode M5, 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 are bent in opposite directions with respect to each other with respect to the length direction A.

[0290] Specifically, when the bending mode is the analog single-bending control mode M4 or the coordinated bending control mode M5, the drive controller 260B controls the first up-down bending wire driving portion 251 and the second up-down bending wire driving portion 253 based on the rotation operation of the first angle knob 320, thereby driving the wires (the first upper bending wire 161u and the first lower bending wire 161d) that cause the first bending portion 113 to bend in the UD direction and the wires (the second upper bending wire 162u and the second lower bending wire 162d) that cause the second bending portion 114 to bend in the UD direction. In addition, the drive controller 260B controls the first left-right bending wire driving portion 252 and the second left-right bending wire driving portion 254 based on the rotation operation of the second angle knob 330, thereby driving the wires (the first left bending wire 161l and the first right bending wire 161r) that cause the first bending portion 113 to bend in the LR direction and the wires (the second left bending wire 162l and the second right bending wire 162r) that cause the second bending portion 114 to bend in the LR direction.

[0291] When the bending mode is the analog single-bending transition mode M6, the drive controller 260B controls at least one of the first bending portion 113 and the second bending portion 114. The drive controller 260B drives at least one of the first bending wire 161 and the second bending wire 162 so that the bending portion 112 transitions to the single-bending shape.

[0292] When the bending mode is the simulated single-bending transition mode M6, the drive controller 260B can also drive control the second bending portion 114 on the basis of the bending rate of the first bending portion 113, thereby making the bending rates of the first bending portion 113 and the second bending portion 114 substantially uniform. Conversely, the drive controller 260B can also drive control the first bending portion 113 on the basis of the bending rate of the second bending portion 114, thereby making the bending rates of the first bending portion 113 and the second bending portion 114 substantially uniform. Whether to drive control on the basis of the bending rate of the first bending portion 113 or on the basis of the bending rate of the second bending portion 114 can be determined on the basis of the previous bending mode. For example, in the case where the previous bending mode of the simulated single-bending transition mode M6 is the first-bending-portion control mode (the front-end-side bending-portion control mode) M1, the second bending portion 114 is drive controlled on the basis of the bending rate of the first bending portion 113.

[0293] When the bending mode is shifted from another bending mode to the simulated single-bending control mode M4, the bending portion 112 is sometimes not a single-bending shape but a multi-stage bending shape. The multi-stage bending shape refers to, for example, a bending shape in which the first bending portion 113 and the second bending portion 114 are bent in different directions with respect to the length direction A or a bending shape in which the bending rates are different even if the first bending portion 113 and the second bending portion 114 are bent in the same direction. In this case, the drive controller 260B shifts the bending mode to the simulated single-bending transition mode M6 to transition the bending portion 112 to a single-bending shape.

[0294] When the bending mode is shifted from another bending mode to the simulated single-bending control mode M4, in the case where the bending portion 112 is already a single-bending shape, the drive controller 260B shifts the bending mode to the simulated single-bending control mode M4 without passing through the simulated single-bending transition mode M6.

[0295] When the bending mode is the simulated single-bending transition mode M6, the drive controller 260B invalidates the rotation operation of the first angle knob 320 and the second angle knob 330. The drive controller 260B transitions the bending portion 112 to a single-bending shape regardless of the rotation operation of the first angle knob 320 and the second angle knob 330.

[0296] In addition, when the bending mode is the simulated single-bending transition mode M6, the drive controller 260B can also 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, make at least one of the first bending portion 113 and the second bending portion 114 act to transition to a single-bending shape.

[0297] After transforming the shape of the bent portion 112 into a single-bend shape, the drive controller 260B switches the bending mode from the simulated single-bend transformation mode M6 to the simulated single-bend control mode M4. The drive controller 260B also enables the rotational operation of the first angle knob 320 and the second angle knob 330.

[0298] [Operating Device 300B]

[0299] 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. FIG. 29 The operating device 300B shown is equipped with a second clamp jaw fixing device 360.

[0300] FIG. 29 This is a diagram showing the toggle switch 340B.

[0301] The switch 340B is mounted on the upper part of the operation unit body 310, similar to the switch 340 in the first embodiment, and is operated by the thumb of the left hand L. The switch 340B switches the bending mode of the bending portion 112 of the endoscope 100. The switch 340B has a lever switch 341B and a push-button switch 342B.

[0302] like FIG. 2 As shown, lever switch 341B can move to three positions: upward (first position) L1, downward (second position) L2, and center (third position) L3. Push-button switch 342B can move to two positions: standard position B1 and pressed position B2 (from standard position B1). Push-button switch 342B has a locking mechanism that holds push-button switch 342B in the pressed position B2 until it is pressed again.

[0303] When lever switch 341B tilts upwards (UPR) to move to the upper position L1, the bending mode becomes the first bending control mode M1. When lever switch 341B tilts downwards (LWR) to move to the lower position L2, the bending mode becomes the second bending control mode M2. When lever switch 341B is positioned in the central position L3, the bending mode becomes the coordinated control mode M3. In the coordinated control mode M3, when push-button switch 342B is positioned in the standard position B1, the bending mode becomes the simulated single bending control mode M4. In the coordinated control mode M3, when push-button switch 342B is positioned in the pressed position B2, the bending mode becomes the coordinated bending control mode M5. The selected bending mode is sent to the drive controller 260B of the drive unit 200B.

[0304] The central position (third position) L3 is located on a path of the lever switch 341B moving from one of the upper position (first position) LI and the lower position (second position) L2 to the other. Therefore, when the surgeon S switches the bending mode from one of the first bending portion control mode Ml and the second bending portion control mode M2 to the other, the bending mode must pass through the coordinated control mode M3.

[0305] Next, a method of using the electric endoscope system 1000B according to the present embodiment will be described. Specifically, a surgical operation of observing and treating a lesion of a tube wall formed in the large intestine using the electric endoscope system 1000B will be described.

[0306] The surgeon S inserts the insertion portion 110 of the endoscope 100 into the large intestine from the anus of the patient P with the distal end portion. As shown in FIG. 10, the surgeon S operates the in-vivo soft portion 119 with the right hand R while observing the captured image displayed on the display device 900, and moves the insertion portion 110 so that the distal end portion 111 approaches the lesion. In addition, the surgeon S operates the first angle knob 320 and the second angle knob 330 of the operation device 300B with the left hand L so that the bending portion 112 bends as needed. FIG. 30

[0307] The surgeon S sets the bending mode of the bending portion 112 to the simulated single-bending control mode M4, for example, in the case of inserting the insertion portion 110 into the large intestine. The drive controller 260B bends the bending portion 112 as one bending portion. The bending portion 112 easily bends largely in one direction and passes through the bending portion in the large intestine. Therefore, the surgeon S can operate the operation device 300B to insert the insertion portion 110 into the large intestine as with the existing soft endoscope that does not have a bending function (multi-stage bending function) in which the bending portion is bent in multiple stages.

[0308] The surgeon S sets the bending mode of the bending portion 112 to the second bending portion control mode M2, for example, in the case of wanting to change the field-of-view direction of the imaging portion 111c approaching the lesion. The drive controller 260B bends only the second bending portion 114. The bending portion 112 bends only the base end side, and thus the field-of-view direction of the imaging portion 111c changes slowly. Therefore, the surgeon S easily controls the change in the field-of-view direction of the imaging portion 111c.

[0309] FIGS. 31-37 FIG. 14 is a view showing the bending portion 112 controlled in the coordinated bending control mode M5.

[0310] The surgeon S sets the bending mode of the bending portion 112 to the coordinated bending control mode M5, for example, in the case of wanting to move the field-of-view direction in the lateral direction. As shown in FIG. 14, the drive controller 260B bends the first bending portion 113 and the second bending portion 114 in the coordinated bending control mode M5. The bending portion 112 is bent in the coordinated bending control mode M5. FIG. 31 ​As shown, the drive controller 260B causes the first bending portion 113 and the second bending portion 114 to bend in opposite directions with respect to the length direction A. That is, in a case where the second bending portion 114 is bent by an angle a with respect to the length direction A, the first bending portion 113 is bent by an angle -a with respect to the length direction A. As a result, the field of view direction of the imaging portion 111c is maintained to be substantially fixed. The surgeon S easily changes the position of the distal end portion 111 in a state where the field of view direction of the imaging portion 111c is maintained to be substantially fixed.

[0311] The surgeon S sets the bending mode of the bending portion 112 to the first bending portion control mode M1, for example, in a case where the periphery of the affected part is incised by the treatment instrument 400. The drive controller 260B causes only the first bending portion 113 to bend. The bending portion 112 is bent only on the distal end side, and thus the radius of rotation is small. Therefore, the surgeon S easily moves the treatment portion 410 of the treatment instrument 400, which protrudes from the opening portion 111a of the distal end portion 111, in a desired direction in conjunction with the bending of the bending portion 112, and easily performs treatment on the affected part or the like.

[0312] The surgeon S sets the bending mode of the bending portion 112 to the simulated single bending control mode M4, for example, in a case where the insertion portion 110 is pulled out from the large intestine after the surgical operation is completed. In a case where the bending portion 112 is not a single bending shape but a multi-stage bending shape, the drive controller 260B causes the bending mode to shift to the simulated single bending control mode M4 via the simulated single bending transition mode M6. As a result, after the bending mode is set to the simulated single bending control mode M4, the surgeon S can set the bending portion 112 to a single bending shape and smoothly perform the processing.

[0313] According to the electric endoscope system 1000B of the present embodiment, it is possible to more effectively perform observation or treatment using the endoscope 100. Since the drive controller 260B can drive the bending portion 112 by the plurality of bending modes, the surgeon S can appropriately control the bending portion 112 for each scene in various scenes in the surgical operation using the endoscope 100. Therefore, it is possible to reduce the burden of the surgeon S on the surgical operation, and it is possible to shorten the operation time.

[0314] The surgeon S can operate the bending portion 112 having the bending function (multi-stage bending function) that bends in two stages by the first bending portion 113 and the second bending portion 114 only by the first angle knob 320 and the second angle knob 330 by switching the bending mode by the switching switch 340B. The operation device 300B can not be divided into an angle knob or the like that operates the first bending portion 113 and an angle knob or the like that operates the second bending portion 114. Therefore, the operation device 300B is easily downsized, and the surgeon S easily operates the operation device 300B with one hand.

[0315] The above describes the second embodiment of the present application with reference to the drawings, but the specific structure is not limited to this embodiment, and design changes and the like within a range not departing from the gist of the present application are also included. Furthermore, the structural elements shown in the above embodiments and modified examples can be appropriately combined to constitute.

[0316] (Modified example 2-1)

[0317] In the above embodiment, when the bending mode is the coordinated bending control mode M5, the drive controller 260B bends the first bending portion 113 and the second bending portion 114 in opposite directions with respect to the length direction A. However, the driving method of the bending portion 112 controlled in the coordinated bending control mode M5 is not limited to this. For example, the drive controller 260B can also bend the first bending portion 113 and the second bending portion 114 in a manner that maintains the posture of the front end of the bending portion 112. The angles at which the first bending portion 113 and the second bending portion 114 are bent with respect to the length direction A are calculated by the drive controller 260B on the basis of the posture of the front end of the bending portion 112.

[0318] (Third embodiment)

[0319] Reference FIG. 31 An electric endoscope system 1000C of a third embodiment of the present application will be described. In the following description, for structures common to those already described, the same reference numerals are annotated and repeated description is omitted. FIG. 31 is a whole view of the electric endoscope system 1000C of the present embodiment.

[0320] [Electric endoscope system 1000C]

[0321] As shown in FIG. 32 , the electric endoscope system 1000C is a medical system that performs observation and treatment of the inside of a patient P lying on his or her back on an operating table T. The electric endoscope system 1000C is provided with an endoscope 100C, a drive device 200C, an operation 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.

[0322] [Endoscope 100C]

[0323] The endoscope 100C is provided with an insertion portion 110, a connecting portion 120, an extracorporeal flexible portion 140, a detachable portion 150C, a bending wire 160, and an internal object 170. The insertion portion 110, the connecting portion 120, the extracorporeal flexible portion 140, and the detachable portion 150C are connected in this order from the front end side.

[0324] Attachment / detachment section 150C

[0325] As shown in FIG. 33 , attachment / detachment section 150C has a first attachment / detachment section 1503 attached to driving device 200C and a second attachment / detachment section 1502 attached to image control device 500. In addition, first attachment / detachment section 1503 and second attachment / detachment section 1502 can be an integrated attachment / detachment section.

[0326] Internal path 101 formed inside extracorporeal soft section 140 branches into first attachment / detachment section 1503 and second attachment / detachment section 1502. Bend line 160 and gas / suction tube 172 are inserted through first attachment / detachment section 1503. Camera cable 173 and light guide 174 are inserted through second attachment / detachment section 1502.

[0327] FIG. 34 is a view showing first attachment / detachment section 1503 before attachment to driving device 200C.

[0328] First attachment / detachment section 1503 has a first upper / lower bend line attachment / detachment section 151C, a first left / right bend line attachment / detachment section 152C, a second upper / lower bend line attachment / detachment section 153C, and a second left / right bend line attachment / detachment section 154C.

[0329] First upper / lower bend line attachment / detachment section 151C is a mechanism that links lines (first upper bend line 161u and first lower bend line 161d) that bend first bend section 113 in the UD direction to driving device 200C attachably / detachably.

[0330] First left / right bend line attachment / detachment section 152C is a mechanism that links lines (first left bend line 1611 and first right bend line 161r) that bend first bend section 113 in the LR direction to driving device 200C attachably / detachably.

[0331] Second upper / lower bend line attachment / detachment section 153C is a mechanism that links lines (second upper bend line 162u and second lower bend line 162d) that bend second bend section 114 in the UD direction to driving device 200C attachably / detachably.

[0332] Second left / right bend line attachment / detachment section 154C is a mechanism that links lines (second left bend line 1621 and second right bend line 162r) that bend second bend section 114 in the LR direction to driving device 200C attachably / detachably.

[0333] First left / right bend line attachment / detachment section 152C, second upper / lower bend line attachment / detachment section 153C, and second left / right bend line attachment / detachment section 154C are configured identically to first upper / lower bend line attachment / detachment section 151C, and therefore, illustration and description thereof are omitted.

[0334] FIG. 33is a view showing the first upper and lower curved line attachment / detachment portion 151C before being assembled to the drive device 200C. FIG. 34 is a view showing the first upper and lower curved line attachment / detachment portion 151C assembled to the drive device 200C. The first upper and lower curved line attachment / detachment portion 151C has a support member 155, a first rotating drum 156, a second rotating drum 157, a connecting member 158, and a tension sensor 159.

[0335] The support member 155 supports the first rotating drum 156, the second rotating drum 157, and the connecting member 158. The support member 155 has a protrusion 155a for attachment / detachment detection, which protrudes on the proximal end side of the first upper and lower curved line attachment / detachment portion 151C, and a plurality of deflection wheels 155p.

[0336] The deflection wheels 155p change the transport direction of the first upper curved line 161u, which penetrates the extracorporeal soft portion 140, and guide the first upper curved line 161u to the first rotating drum 156. Further, the deflection wheels 155p change the transport direction of the first lower curved line 161d, which penetrates the extracorporeal soft portion 140, and guide the first lower curved line 161d to the second rotating drum 157.

[0337] The first rotating drum 156 is supported to the support member 155 so as to be rotatable about a first drum rotating shaft 156r, which extends in the length direction A. The first rotating drum 156 has a first winding drum 156a, a first gear 156b, and a first coupling portion 156c.

[0338] The first winding drum 156a draws or feeds out the first upper curved line (first curved line) 161u by rotating about the first drum rotating shaft 156r. The first upper curved line 161u is drawn by winding on the first winding drum 156a when the first winding drum 156a rotates clockwise as viewed from the distal end side toward the proximal end side. Conversely, the first upper curved line 161u is fed out from the first winding drum 156a when the first winding drum 156a rotates counterclockwise.

[0339] The first gear 156b is a spur gear that rotates about the first drum rotating shaft 156r. The first gear 156b is fixed to the first winding drum 156a and rotates integrally with the first winding drum 156a.

[0340] The first coupling portion 156c is a circular plate member that rotates about the first roller rotation axis 156r. The first coupling portion 156c is fixed to the base end of the first winding roller 156a and rotates integrally with the first winding roller 156a. The first coupling portion 156c is exposed on the base end side of the first upper and lower curved line attachment / detachment portion 151C. Two first fitting protrusions 156d are formed on the face on the base end side of the first coupling portion 156c. The two first fitting protrusions 156d are formed on both sides with the first roller rotation axis 156r interposed therebetween.

[0341] The second rotating roller 157 is supported to the support member 155 so as to be able to rotate about the second roller rotation axis 157r that extends in the longitudinal direction A. The second rotating roller 157 has a second winding roller 157a, a second gear 157b, and a second coupling portion 157c.

[0342] The second winding roller 157a pulls or feeds out the first lower curved line (second curved line) 161d by rotating about the second roller rotation axis 157r. The first lower curved line 161d is pulled by being wound on the second winding roller 157a by the second winding roller 157a rotating counterclockwise when viewed from the front end side toward the base end side. Conversely, the first lower curved line 161d is fed out from the second winding roller 157a by the second winding roller 157a rotating clockwise.

[0343] The second gear 157b is a spur gear that rotates about the second roller rotation axis 157r. The second gear 157b is fixed to the second winding roller 157a and rotates integrally with the second winding roller 157a.

[0344] The second coupling portion 157c is a circular plate member that rotates about the second roller rotation axis 157r. The second coupling portion 157c is fixed to the base end of the second winding roller 157a and rotates integrally with the second winding roller 157a. The second coupling portion 157c is exposed on the base end side of the first upper and lower curved line attachment / detachment portion 151C. Two second fitting protrusions 157d are formed on the face on the base end side of the second coupling portion 157c. The two second fitting protrusions 157d are formed on both sides with the second roller rotation axis 157r interposed therebetween.

[0345] The link member (switching mechanism) 158 is a member that links the first rotating roller 156 and the second rotating roller 157. The link member 158 has a cylindrical member 158a, a link gear 158b, and an elastic member 158c.

[0346] The cylindrical member 158a is supported on the support member 155 in a manner that allows it to rotate about a third rotation axis 158r extending along the length direction A and to move forward and backward along the length 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 up-down curved line loading and unloading portion 151C.

[0347] The linkage gear 158b is a spur gear that rotates around the third rotating shaft 158r. The linkage gear 158b is fixed to the cylindrical member 158a and rotates integrally with the cylindrical member 158a.

[0348] The elastic member 158c, such as a spring, applies a force to the cylindrical member 158a and the linkage gear 158b towards their base ends. After being forced by the elastic member 158c, the cylindrical member 158a and the linkage gear 158b are positioned at their base ends (first position) within a range of forward and backward movement. FIG. 35 As shown, when the first upper and lower bending line mounting and dismounting part 151C is assembled to the drive device 200C, the base end of the cylindrical member 158a contacts the drive device 200C, thereby overcoming the reaction force of the elastic member 158c and pressing the cylindrical member 158a into the base end side position (second position).

[0349] like FIG. 32 As shown, when the linkage gear 158b is configured in the first position, the linkage gear 158b meshes with the first gear 156b and the second gear 157b. As a result, the first rotating roller 156 and the second rotating roller 157 rotate in conjunction, and the first upper curved line 161u and the first lower curved line 161d are pulled or sent out in conjunction in a loop (loop state).

[0350] like FIG. 32 As shown, when the linkage gear 158b is configured in the second position, the linkage gear 158b does not mesh with the first gear 156b and the second gear 157b. As a result, the first rotating roller 156 and the second rotating roller 157 rotate without linkage, and the first upper curved line 161u and the first lower curved line 161d are independently pulled or sent out (opposing state).

[0351] In a state in which the first upper and lower bending wire attachment and detachment section 151C is not attached to the driving device 200C, the first rotary drum 156 and the second rotary drum 157 are rotated in linkage. Specifically, in a case in which the linkage gear 158b is rotated counterclockwise when viewed from the front end side toward the base end side, the first rotary drum 156 is rotated clockwise, and the second rotary drum 157 is also rotated clockwise. In a case in which the linkage gear 158b is rotated clockwise when viewed from the front end side toward the base end side, the first rotary drum 156 is rotated counterclockwise, and the second rotary drum 157 is also rotated counterclockwise. Thereby, even in a case in which the bending section 112 is bent by an external force, the first upper bending wire 161u and the first lower bending wire 161d are not loosened, and it is possible to maintain the relationship between the rotation of the rotary drums (the first rotary drum 156 and the second rotary drum 157) and the bending of the bending section 112 in the UD direction.

[0352] For example, even in a case in which the first upper bending wire 161u is pulled toward the front end side by the bending of the bending section 112 due to some external force, and the first rotary drum 156 is rotated counterclockwise, the second rotary drum 157 is also rotated counterclockwise in linkage, and the first lower bending wire 161d that is loosened due to the bending of the bending section 112 is wound. As a result, loosening of the bending wire 160 does not occur.

[0353] [Driving device 200C]

[0354] FIG. 33 is a functional block diagram of the driving device 200C.

[0355] The driving device 200C includes an adapter 210C, an operation reception section 220, an air feeding and suction driving section 230, a wire driving section 250C, and a driving controller 260C.

[0356] As shown in FIG. 32 , the adapter 210C includes a first adapter 211 and a second adapter 212C. The first adapter 211 is an adapter that is attached to and detached from the operation cable 301. The second adapter 212C is an adapter that is attached to and detached from the first attachment and detachment section 1503 of the endoscope 100C.

[0357] The wire driving section 250C is coupled to the first upper and lower bending wire attachment and detachment section 151C, the first left and right bending wire attachment and detachment section 152C, the second upper and lower bending wire attachment and detachment section 153C, and the second left and right bending wire attachment and detachment section 154C, and drives the bending wire 160.

[0358] As shown in FIG. 34 , the wire driving section 250C includes a first upper and lower bending wire driving section 251C, a first left and right bending wire driving section 252C, a second upper and lower bending wire driving section 253C, and a second left and right bending wire driving section 254C.

[0359] The first upper and lower bending line drive unit 251C is a mechanism that is connected to the first upper and lower bending line loading and unloading unit 151C to drive the lines (first upper bending line 161u and first lower bending line 161d) that bend the first bending section 113 in the UD direction.

[0360] The first left-right bending line drive unit 252C is a mechanism connected to the first left-right bending line loading and unloading unit 152C to drive the lines (first left bending line 161l and first right bending line 161r) that cause the first bending section 113 to bend in the LR direction.

[0361] The second upper and lower bending line drive unit 253C is a mechanism that is connected to the second upper and lower bending line loading and unloading unit 153C to drive the line (second upper bending line 162u and second lower bending line 162d) that bends the second bending section 114 in the UD direction.

[0362] The second left-right bending line drive unit 254C is a mechanism that is connected to the second left-right bending line loading and unloading unit 154C to drive the line (second left bending line 162l and second right bending line 162r) that causes the second bending section 114 to bend in the LR direction.

[0363] The first left-right bending line drive unit 252C, the second up-down bending line drive unit 253C, and the second left-right bending line drive unit 254C have the same structure as the first up-down bending line drive unit 251C, therefore, the illustrations and descriptions are omitted.

[0364] like FIG. 34 As shown, the first upper and lower bending line drive unit 251C has a support member 255, a first upper bending line drive unit 256, a first lower bending line drive unit 257, a locking member 258, and a loading and unloading sensor 259.

[0365] The first upper bending line drive unit 256 is connected to the first rotating roller 156 of the first upper and lower bending line loading and unloading unit 151C to drive the first upper bending line 161u. The first upper bending line drive unit 256 includes a first shaft 256a, a first motor unit 256b, a first connected part 256c, a first torque sensor 256e, a first engagement detection sensor 256f, and a first elastic member 256s.

[0366] The first shaft 256a is supported on the support member 255 in a manner that allows it to rotate about the first shaft rotation axis 256r and to move forward and backward along the length direction A. When the first loading and unloading part 1503 of the endoscope 100C is assembled to the drive device 200C, the first shaft rotation axis 256r is aligned with the first roller rotation axis 156r.

[0367] The first motor section 256b has a first motor such as a DC motor, a first motor driver that drives 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 the drive controller 260C.

[0368] The first coupled section 256c is a circular plate member that rotates about the first shaft rotation axis 256r. The first coupled section 256c is fixed to the front end of the first shaft 256a and rotates integrally with the first shaft 256a. As shown in FIG. 33 two first fitting recesses 256d are formed on the front end side of the first coupled section 256c. The two first fitting recesses 256d are formed on the two sides with the first shaft rotation axis 256r in between.

[0369] As shown in FIG. 32 the first fitting convex section 156d is fitted to the first fitting recess 256d, and the first coupled section 156c is coupled to the first coupled section 256c. As a result, the rotation of the first shaft 256a based on the first motor section 256b is transmitted to the first rotating drum 156. When the first shaft 256a is rotated clockwise as viewed from the front end side toward the base end side, the first upper curved line 161u is drawn in. Conversely, when the first shaft 256a is rotated counterclockwise, the first upper curved line 161u is fed out.

[0370] 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 acquired by the drive controller 260C.

[0371] The first fitting detection sensor 256f detects the fitting of the first fitting convex section 156d to the first fitting recess 256d. As shown in FIG. 34 the first coupled section 256c is moved toward the base end side (A2) together with the first shaft 256a by being pressed by the first coupled section 156c. The first fitting detection sensor 256f detects the fitting of the first fitting convex section 156d to the first fitting recess 256d by detecting the approach of a first fitting detection protrusion 256g provided to the first shaft 256a. The detection result of the first fitting detection sensor 256f is acquired by the drive controller 260C.

[0372] The first elastic member 256s is, for example, a compression spring, and the front end portion is in contact with the first coupled section 256c, and the base end portion is in contact with the support member 255. The first elastic member 256s applies a force to the first coupled section 256c toward the front end side (Al). As shown in FIG. 34As shown, when the first coupling portion 156c is detached, the first coupled portion 256c moves together with the first shaft 256a to the front end side (Al). As a result, the first fitting detection sensor 256f cannot detect the fitting of the first fitting protrusion 156d and the first fitting recess 256d.

[0373] The first lower curved line driving portion 257 is coupled to the second rotating drum 157 of the first upper and lower curved line attaching and detaching portion 151C to drive the first lower curved line 161d. The first lower curved line driving portion 257 has a second shaft 257a, a second motor portion 257b, a second coupled portion 257c, a second torque sensor 257e, a second fitting detection sensor 257f, and a second elastic member 257s.

[0374] The second shaft 257a is supported to the support member 255 so as to be able to rotate around the second shaft rotation axis 257r and be able to advance and retreat along the length direction A. When the first attaching and detaching portion 1501 of the endoscope 100C is attached to the driving device 200C, the second shaft rotation axis 257r coincides with the second drum rotation axis 157r.

[0375] The second motor portion 257b has a second motor such as a DC motor, a second motor driver that drives the second motor, and a second motor encoder. The second motor rotates the second shaft 257a around the second shaft rotation axis 257r. The motor driver is controlled by the driving controller 260C.

[0376] 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. As shown, FIG. 33 As shown, the second coupled portion 257c is exposed on the front end side of the first upper and lower curved line driving portion 251C. Two second fitting recesses 257d are formed on the surface on the front end side of the second coupled portion 257c. The two second fitting recesses 257d are formed on both sides across the second shaft rotation axis 257r.

[0377] As shown, FIG. 33 As shown, the second fitting protrusion 157d is fitted to the second fitting recess 257d, and the second coupling portion 157c is coupled to the second coupled portion 257c. As a result, the rotation of the second shaft 257a based on the second motor portion 257b is transmitted to the second rotating drum 157. By rotating the second shaft 257a counterclockwise when viewed from the front end side toward the base end side, the first lower curved line 161d is drawn. Conversely, by rotating the second shaft 257a clockwise, the first lower curved line 161d is fed out.

[0378] The second torque sensor 257e detects a rotational torque of the second shaft 257a about the second shaft rotation axis 257r. The detection result of the second torque sensor 257e is acquired by the drive controller 260C.

[0379] The second fitting detection sensor 257f detects fitting of the second fitting protrusion 157d and the second fitting recess 257d. As shown in FIG. 17, the second coupled portion 257c moves to the base end side (A2) together with the second shaft 257a by being pressed by the second coupling portion 157c. The second fitting detection sensor 257f detects fitting of the second fitting protrusion 157d and the second fitting recess 257d by detecting approach of the second fitting detection protrusion 257g provided to the second shaft 257a. The detection result of the second fitting detection sensor 257f is acquired by the drive controller 260C. FIG. 34

[0380] The second elastic member 257s is, for example, a compression spring, and a front end portion is in contact with the second coupled portion 257c, and a base end portion is in contact with the support member 255. The second elastic member 257s exerts a force to the second coupled portion 257c to the front end side (Al). As shown in FIG. 17, when the second coupling portion 157c is detached, the second coupled portion 257c moves to the front end side (Al) together with the second shaft 257a. As a result, the second fitting detection sensor 257f cannot detect fitting of the second fitting protrusion 157d and the second fitting recess 257d. FIG. 34

[0381] As shown in FIG. 18, the engagement member 258 is a cylindrical member that is exposed to the front end side of the first up-and-down bending line drive portion 251C. As shown in FIG. 18, when the first up-and-down bending line attachment / detachment portion 151C is attached to the drive device 200C, the engagement member 258 comes in contact with the base end of the cylindrical member 158a, thereby pressing the cylindrical member 158a to the second position against the reaction force of the elastic member 158c. As a result, the first rotating roller 156 and the second rotating roller 157 can rotate independently of each other. FIG. 36 FIG. 36 As shown in FIG. 18, the attachment / detachment sensor 259 detects attachment / detachment of the first up-and-down bending line attachment / detachment portion 151C with respect to the first up-and-down bending line drive portion 251C by detecting engagement and non-engagement with the attachment / detachment detection protrusion 155a. The detection result of the attachment / detachment sensor 259 is acquired by the drive controller 260C.

[0382] As shown in FIG. 18, the attachment / detachment sensor 259 detects attachment / detachment of the first up-and-down bending line attachment / detachment portion 151C with respect to the first up-and-down bending line drive portion 251C by detecting engagement and non-engagement with the attachment / detachment detection protrusion 155a. The detection result of the attachment / detachment sensor 259 is acquired by the drive controller 260C. FIG. 36

[0383] FIG. 36 is a view showing the first up-and-down bending line drive portion 251C to which the first up-and-down bending line attachment / detachment portion 151C is attached. In FIG. 2 ​​​​In the process, the loading and unloading sensor 259 detects that the first upper and lower bending line loading and unloading part 151C is assembled onto the first upper and lower bending line drive part 251C.

[0384] like FIG. 37 As shown, when the first connecting portion 156c contacts the first connected portion 256c but the first engaging protrusion 156d and the first engaging recess 256d are not engaged, the first engagement detection sensor 256f cannot detect the engagement of the first engaging protrusion 156d and the first engaging recess 256d. In this case, the drive controller 260C rotates the first connected portion 256c to a position where the first engaging recess 256d and the first engaging protrusion 156d can engage. As a result, the first connected portion 256c moves towards the front end side (A1) via the first elastic member 256s, thereby engaging the first engaging protrusion 156d and the first engaging recess 256d. The first engagement detection sensor 256f detects the engagement of the first engaging protrusion 156d and the first engaging recess 256d.

[0385] In the engagement operation described above, the drive controller 260C preferably rotates the first connected portion 256c clockwise when viewed from the front end side toward the base end side. Even if the first connecting portion 156c rotates due to the contact friction between the first engaging protrusion 156d and the first connected portion 256c, the first winding wheel 156a rotates in the direction of pulling the first upper curved line 161u, so the first upper curved line 161u will not become slack.

[0386] like FIG. 37 As shown, even when the second connecting portion 157c contacts the second connected portion 257c but the second engaging protrusion 157d and the second engaging recess 257d are not engaged, the drive controller 260C can still engage the second engaging protrusion 157d and the second engaging recess 257d by rotating the second connected portion 257c.

[0387] In the engagement operation described above, the drive controller 260C preferably rotates the second connected portion 257c counterclockwise when viewed from the front end side toward the base end side. Even if the second connecting portion 157c rotates due to the contact friction between the second engaging protrusion 157d and the second connected portion 257c, the first lower bending line 161d will not slack because the second winding wheel 157a rotates in the direction of pulling the first lower bending line 161d.

[0388] The drive controller 260C compares the values of the first torque sensor 256e and the second torque sensor 257e. In a case where the value of the first torque sensor 256e is larger, the drive controller 260C rotates the first motor section 256b and the second motor section 257b in a manner to feed out the first upper curved line 161u and to pull in the first lower curved line 161d.

[0389] On the contrary, in a case where the value of the second torque sensor 257e is larger, the drive controller 260C rotates the first motor section 256b and the second motor section 257b in a manner to pull in the first upper curved line 161u and to feed out the first lower curved line 161d.

[0390] 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 section 256b and the second motor section 257b. As a result, the tension of the opposing lines (the first upper curved line 161u and the first lower curved line 161d) becomes equal, and it is possible to make the insertion section 110 into a straight line shape.

[0391] The drive controller 260C refers to the values of the first torque sensor 256e and the second torque sensor 257e. In a case where the referred value is lower than a predetermined torque sensor value, the drive controller 260C rotates the first motor section 256b and the second motor section 257b in a manner to pull in the first upper curved line 161u and the first lower curved line 161d.

[0392] On the contrary, in a case where the referred value is higher than the predetermined torque sensor value, the drive controller 260C rotates the first motor section 256b and the second motor section 257b in a manner to feed out the first upper curved line 161u and the first lower curved line 161d.

[0393] If the values of the first torque sensor 256e and the second torque sensor 257e are equal to the predetermined torque sensor value, the drive controller 260C stops the first motor section 256b and the second motor section 257b. As a result, it is possible to adjust the line tension to the predetermined value.

[0394] With the above-described structure, when the first upper and lower curved line attachment section 151C is attached to the first upper and lower curved line drive section 251C, the first upper curved line drive section 256 is able to independently drive the first upper curved line 161u, and the first lower curved line drive section 257 is able to independently drive the first lower curved line 161d. Therefore, even in a case where the distance from the curved section 112 of the endoscope 100C to the drive device 200C is longer than that of the conventional flexible endoscope, it is difficult to generate slack at the time of feeding out due to elongation of the line at the time of pulling in the line, and it is possible to highly accurately control the bending operation of the curved section 112.

[0395] The drive controller 260C controls the entire drive device 200C. The drive controller 260C acquires the operation input received by the operation receiving section 220. The drive controller 260C controls the air feeding and suction drive section 230 and the wire drive section 250C on the basis of the acquired operation input.

[0396] The drive controller 260C is a computer that has a processor, a memory, a storage section capable of storing programs and data, and an input / output control section. The functions of the drive controller 260C are realized by the processor executing the programs. At least a part of the functions of the drive controller 260C can also be realized by a dedicated logic circuit.

[0397] The drive controller 260C is expected to have high arithmetic performance so that the plurality of motors that drive the plurality of bending wires 160 are controlled with high precision.

[0398] Next, the method of using the electric endoscope system 1000C of the present embodiment will be described. Specifically, the surgical operation of observing and treating a lesion formed in the wall of the large intestine using the electric endoscope system 1000C will be described.

[0399] The surgeon S inserts the insertion section 110 of the endoscope 100C into the large intestine from the anus of the patient P from the front end. As shown in FIG. 37 The surgeon S operates the in-vivo soft section 119 with the right hand R while observing the captured image displayed on the display device 900, and moves the insertion section 110 so that the front end section 111 approaches the lesion.

[0400] FIGS. 38-42 is a view showing an example of use of the bending section 112 of the electric endoscope system 1000C.

[0401] The surgeon S sets the bending mode to the second bending section control mode M2. The surgeon S operates the first angle knob 320, pulls the second upper bending wire 162u, and feeds out the second lower bending wire 162d. In addition, the surgeon S operates the second angle knob 330, pulls the second left bending wire 162l, and feeds out the second right bending wire 162r. As a result, as shown in FIG. 38 The second bending section 114 is bent greatly to a so-called "J-turn" shape.

[0402] The electric endoscope system 1000C can independently drive the pair of bending wires that bend the bending portion 112 in the UD direction, pull one side and feed out the other side. Further, the electric endoscope system 1000C can independently drive the pair of bending wires that bend the bending portion 112 in the LR direction, pull one side and feed out the other side. Therefore, compared with the electric endoscope system 1000 of the first embodiment, the electric endoscope system 1000C can accurately and greatly bend the bending portion 112.

[0403] Since the second bending portion 114 is greatly bent, as shown in FIG. 38 the second bending portion 114 can be brought into contact with the tube wall IW of the opposing large intestine. As a result, the second bending portion 114 can also be firmly fixed by the tube wall IW of the opposing large intestine. Therefore, the operator S can move the first bending portion 113 located at the distal end of the fixed second bending portion 114, observe the affected portion, and easily perform treatment on the affected portion by the treatment portion 410 of the treatment instrument 400.

[0404] According to the electric endoscope system 1000C of the present embodiment, observation or treatment using the endoscope 100C can be more effectively performed. The driving mechanism that drives the bending portion 112 is not provided in the operation device 300 but in the driving device 200C. Therefore, the bending wires 160 can be provided with dedicated bending wire driving portions, respectively. The driving controller 260C can independently drive the bending wires 160, and therefore, the bending operation of the bending portion 112 can be controlled with high precision.

[0405] According to the electric endoscope system 1000C of the present embodiment, in a state where the attachment / detachment portion 150C of the endoscope 100C is not fitted to the driving device 200C, the pair of bending wires corresponding to the UD direction or the LD direction becomes a loop state, and for example, even in a case where the bending portion 112 is bent by some external force and any of the bending wires 160 is pulled toward the distal end side, relaxation of the bending wire 160 does not occur.

[0406] According to the electric endoscope system 1000C of the present embodiment, in a state where the attachment / detachment portion 150C of the endoscope 100C is fitted to the driving device 200C, without performing an additional operation, the state where the pair of bending wires corresponding to the UD direction or the LD direction is independently pulled or fed out, respectively (the antagonistic state) is achieved.

[0407] The third embodiment of the present application has been described above with reference to the drawings, but the specific structure is not limited to this embodiment, and design changes and the like within a range not departing from the gist of the present application are also included. Further, the structural elements shown in the above embodiments and modified examples can be appropriately combined.

[0408] (Modified example 3-1)

[0409] In the above embodiment, the connecting member 158 connects the first rotating drum 156 and the second rotating drum 157 by the linkage gear 158b. However, the manner of the connecting member 158 is not limited to this. For example, the connecting member 158 can connect the first rotating drum 156 and the second rotating drum 157 by a belt.

[0410] (Modified example 3-2)

[0411] In the above embodiment, the driving object of the driving device 200C of the electric endoscope system 1000C is the endoscope 100C. However, the driving object of the driving device 200C is not limited to this. The driving object of the driving device 200C can also be a medical device such as a mechanical arm.

[0412] (Fourth embodiment)

[0413] Reference FIG. 38 An electric endoscope system 1000D of a fourth embodiment of the present application will be described. In the following description, for structures common to those already described, the same reference numerals are annotated and repeated description is omitted. FIG. 38 is a whole view of the electric endoscope system 1000D of the present embodiment.

[0414] [Electric endoscope system 1000D]

[0415] As shown in FIG. 39 , the electric endoscope system 1000D is a medical system that performs observation and treatment of the inside of a patient P lying on his or her back on an operating table T. The electric endoscope system 1000D is provided with 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. In addition, in the operating device 300 shown in FIG. 40 , a second forceps port fixing instrument 360 is not installed.

[0416] [Endoscope 100D]

[0417] As shown in FIG. 41 , the endoscope 100D is provided with an insertion section 110, a connecting section 120D, an extracorporeal soft section 140, a detachable section 150, a bending wire 160, and an internal object 170. The insertion section 110, the connecting section 120D, the extracorporeal soft section 140, and the detachable section 150 are connected in this order from the distal end side. The connecting section 120D can connect an extension channel tube 130.

[0418] [Connecting section 120D]

[0419] The connecting portion 120D is a member that connects the in-vivo soft portion 119 of the insertion portion 110 and the in-vivo soft portion 140. The connecting portion 120D includes a cylindrical member 121, a connecting portion main body 122, a seal portion 123, a bearing portion 124D, a cover member 125, a forceps port 126, and a three-pronged branch pipe 127.

[0420] FIG. 8 is a perspective view of the cylindrical member 121 and the bearing portion 124D.

[0421] The bearing portion 124D connects the connecting portion main body 122 and the cylindrical member 121 so as to be rotatable about a rotation axis extending in the length direction A. Specifically, the bearing portion 124D is fixed to the connecting portion main body 122. The bearing portion 124D supports the cylindrical member 121 so as to be rotatable about a rotation axis extending in the length direction A.

[0422] FIG. 42 is an exploded perspective view of the cylindrical member 121 and the bearing portion 124D.

[0423] The bearing portion 124D includes a first bearing member 124a, a first screw 124c, a second bearing member 124d, and a second screw 124f.

[0424] The first bearing member 124a is formed in a cylindrical shape. The inner peripheral surface of the first bearing member 124a is fitted to the outer peripheral surface of the cylindrical member 121. The first bearing member 124a is formed with a first groove 124b extending in the circumferential direction C. The first groove 124b is a groove that penetrates the first bearing member 124a in the radial direction R. The length of the circumferential direction C of the first groove 124b is about 3 / 4 of the circumference.

[0425] The first screw 124c is a screw that is installed to the outer peripheral surface of the cylindrical member 121 and penetrates the first groove 124b. The first bearing member 124a is limited in the rotation angle in the circumferential direction C by the first screw 124c. The position of the first bearing member 124a in which the first screw 124c is disposed at the middle position of the first groove 124b is set as a "first reference position". The first bearing member 124a is rotatable in the circumferential direction C to ±135 degrees with the first reference position as a reference.

[0426] The second bearing member 124d is formed in a cylindrical shape. The outer peripheral surface of the second bearing member 124d is fixed to the connecting portion main body 122. The inner peripheral surface of the second bearing member 124d is fitted to the outer peripheral surface of the first bearing member 124a. The second bearing member 124d is formed with a second groove 124e extending in the circumferential direction C. The second groove 124e is a groove that penetrates the second bearing member 124d in the radial direction R. The length of the circumferential direction C of the second groove 124e is about 3 / 4 of the circumference.

[0427] The second screw 124f is a screw mounted to the outer circumferential surface of the first bearing member 124a, and penetrates the second groove 124e. The second screw 124f is disposed on the opposite side with respect to the first screw 124c across the central axis O in the length direction A in the first bearing member 124a disposed in the first reference position. The second bearing member 124d is limited in the rotation angle in the circumferential direction C by the second screw 124f. The position of the second bearing member 124d in which the second screw 124f is disposed at the intermediate position of the second groove 124e is set as the "second reference position". The second bearing member 124d is rotatable in the circumferential direction C to ±135 degrees with the second reference position as the reference.

[0428] The position of the bearing portion 124D in which the first bearing member 124a is disposed in the first reference position and the second bearing member 124d is disposed in the second reference position is set as the "reference position". The bearing portion 124D is rotatable in the circumferential direction C to ±270 degrees with the reference position as the reference.

[0429] Next, the method of using the electric endoscope system 1000D of the present embodiment will be described. Specifically, the surgical operation of observing and treating a lesion of a tube wall formed in the large intestine using the electric endoscope system 1000D will be described.

[0430] FIGS. 43-48 is a view showing the treatment using the electric endoscope system 1000D.

[0431] The surgeon S inserts the insertion portion 110 of the endoscope 100D into the large intestine from the anus of the patient P from the distal end. The surgeon S operates the in-vivo soft portion 119 with the right hand R while observing the captured image displayed on the display device 900, and moves the insertion portion 110 so that the distal end portion 111 approaches the lesion. In addition, the surgeon S operates the first angle knob 320 and the second angle knob 330 of the operation device 300 with the left hand L so that the bending portion 112 is bent as needed.

[0432] The assistant AS holds the base end portion of the extension channel tube 130. The assistant AS inserts the treatment instrument 400 from the base end opening, and inserts the treatment instrument 400 through the extension channel tube 130 and the forceps port 126 so as to penetrate the channel tube 171. The assistant AS operates the treatment instrument 400 while observing the captured image displayed on the display device 900.

[0433] Since the operation device 300 is separated from the forceps port 126 and the extension channel tube 130 into which the treatment instrument 400 is inserted, the surgeon S can focus on the operation of the insertion portion 110 of the endoscope 100D, and the assistant AS can focus on the operation of the treatment instrument 400. The surgeon S and the assistant AS can operate the insertion portion 110 and the treatment instrument 400 even without close coordination.

[0434] The electric endoscope system 1000D according to 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.

[0435] When the surgeon S rotates the internal soft part 119 of the insertion section 110 around a rotation axis extending along the length direction A, only the internal soft part 119 can be rotated. Therefore, the surgeon S can easily perform rotation operations on the internal soft part 119. Furthermore, since the endoscope 100D is separate from the operating device 300, it is not necessary to coordinate the operation of the operating device 300 with the rotation (torsion) operation of the internal soft part 119. Therefore, the surgeon S does not have to impose unreasonable postures on his muscles and bones, and is less prone to fatigue.

[0436] On the other hand, as long as the surgeon S does not rotate the internal soft part 119 of the insertion part 110, the internal soft part 119 will not rotate relative to the external soft part 140. Therefore, even if the surgeon S removes his right hand R from the internal soft part 119 in order to operate the treatment device 400, the internal soft part 119 will not rotate relative to the external soft part 140.

[0437] The bearing portion 124D limits rotation to ±270 degrees in the circumferential direction C with reference to the reference position. Therefore, it is possible to prevent the bearing portion 124D from rotating unrestricted relative to the cylindrical member 121 and the soft part 119 inside the body, which would cause the built-in 170 to twist significantly.

[0438] like FIG. 43 As shown, the forceps jaw 126 for inserting the treatment instrument 400 is provided in the cover member 125 within the connecting portion 120D. Even when the soft part 119 inside the body is rotated about a rotation axis extending along the length direction A, the forceps jaw 126 does not rotate. Therefore, even when the surgeon S rotates the soft part 119 inside the body, the assistant AS can stably operate the treatment instrument 400.

[0439] 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) that can be discarded after the operation. If the extension channel tube 130 is disposed of as a consumable, the number of areas in the electric endoscope system 1000D that require washing of surgical gowns can be reduced.

[0440] The fourth embodiment of the present application has been described above with reference to the drawings, but the specific structure is not limited to this embodiment, and design modifications and the like within a range not departing from the gist of the present application are also included. Furthermore, the structural elements shown in the above embodiments and modifications can be appropriately combined to constitute.

[0441] (Modification 4-1)

[0442] In the above embodiment, the connecting portion 120D that connects the in-vivo soft portion 119 and the in-vitro soft portion 140 is provided to a part of the endoscope 100D. However, the manner of the connecting portion 120D is not limited to this. FIG. 43 is a view showing a connecting portion 120DA that is a modification of the connecting portion 120D. The connecting portion (external connecting portion) 120DA is provided to the outside of the endoscope, and connects the in-vivo soft portion 119 and the in-vitro soft portion 140. The connecting portion 120DA supports the in-vivo soft portion 119 so as to be rotatable about a rotation axis extending in the longitudinal direction A, and supports the in-vitro soft portion 140 so as to be non-rotatable. Therefore, in a case where the surgeon S has rotated the in-vivo soft portion 119 of the insertion portion 110 about the rotation axis extending in the longitudinal direction A, as with the connecting portion 120D, it is possible to rotate only the in-vivo soft portion 119. In addition, since the connecting portion 120DA is fixed by the arm 129, even in a case where the surgeon S has removed his right hand from the in-vivo soft portion 119, the in-vivo soft portion 119 does not move.

[0443] The connecting portion 120DA can also have a motor unit that enables the in-vivo soft portion 119 and the in-vitro soft portion 140 to advance and retreat in the longitudinal direction A. The surgeon S can cause the in-vivo soft portion 119 to advance and retreat by motor control even without directly operating the in-vivo soft portion 119 with his right hand R.

[0444] (Modification 4-2)

[0445] In the above embodiment, the treatment instrument 400 is operated by the assistant AS. In the first embodiment, the treatment instrument 400 is operated by the surgeon S. However, the manner of operation of the treatment instrument 400 is not limited to this. The treatment instrument 400 can also be operated with assistance by a treatment instrument advancing and retreating device that causes the treatment instrument 400 to advance and retreat by motor. The treatment instrument advancing and retreating device is a device appropriately selected from publicly known advancing and retreating devices that enable the treatment instrument 400 to advance and retreat. By using the treatment instrument advancing and retreating device, it is possible to reduce the burden on the surgeon S and the assistant AS, and in addition, it is possible to accurately perform advancing and retreating operations on the treatment instrument 400.

[0446] (Fifth Embodiment)

[0447] Reference FIG. 43An electric endoscope system 1000E of a fifth embodiment of the present application will be described. In the following description, the same reference numerals are annotated for structures common to those already described, and repeated description is omitted. FIG. 44 is a general view of the electric endoscope system 1000E of the present embodiment.

[0448] [Electric endoscope system 1000E]

[0449] As shown in FIG. 45 , the electric endoscope system 1000E is a medical system that performs observation and treatment of a patient P lying on his or her back on an operating table T. The electric endoscope system 1000E is provided with 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.

[0450] [Endoscope 100E]

[0451] As shown in FIG. 6 , the endoscope 100E is provided with an insertion section 110E, a connecting section 120, an extracorporeal flexible section 140E, a detachable section 150, a bending wire 160, and an internal object 170. The insertion section 110E, the connecting section 120, the extracorporeal flexible section 140E, and the detachable section 150 are connected in this order from the distal end side.

[0452] [Insertion section 110E]

[0453] The insertion section 110E is an elongated long member that can be inserted into a lumen. The insertion section 110E has a distal end section 111, a bending section 112, and an intracorporeal flexible section 119E. The distal end section 111, the bending section 112, and the intracorporeal flexible section 119E are connected in this order from the distal end side.

[0454] FIG. 6 is a cross-sectional view of the intracorporeal flexible section 119E.

[0455] The intracorporeal flexible section 119E is a long and flexible tubular member. The bending wire 160, the channel tube 171, the imaging cable 173, and the light guide 174 are inserted through the inside path 101 formed in the intracorporeal flexible section 119E.

[0456] [Extracorporeal flexible section 140E]

[0457] FIG. 7 is a cross-sectional view of the extracorporeal flexible section 140E.

[0458] The extracorporeal flexible section 140E is a long tubular member. The bending wire 160, the gas / suction tube 172, the imaging cable 173, and the light guide 174 are inserted through the inside path 101 formed in the inside of the extracorporeal flexible section 140E.

[0459] The curved lines 160 that are inserted through the inside path 101 of the in-vivo soft portion 119E and the in-vitro soft portion 140E are a first curved line 161 that curves the first curved portion 113 and a second curved line 162 that curves the second curved portion 114.

[0460] The first line sheath 161s that is inserted through the first upper curved line 161u and the first lower curved line 161d is fixed by the fastener 163. Therefore, as shown in FIG. 6, the first upper curved line 161u and the first lower curved line 161d are arranged on both sides in the UD direction in the first curved portion 113, but are arranged adjacently in the in-vivo soft portion 119E and the in-vitro soft portion 140E. FIG. 7

[0461] The first line sheath 161s that is inserted through the first left curved line 1611 and the first right curved line 161r is fixed by the fastener 163. Therefore, as shown in FIG. 7, the first left curved line 1611 and the first right curved line 161r are arranged on both sides in the LR direction in the first curved portion 113, but are arranged adjacently in the in-vivo soft portion 119E and the in-vitro soft portion 140E. FIG. 46

[0462] The second line sheath 162s that is inserted through the second upper curved line 162u and the second lower curved line 162d is fixed by the fastener 163. Therefore, as shown in FIG. 8, the second upper curved line 162u and the second lower curved line 162d are arranged on both sides in the UD direction in the second curved portion 114, but are arranged adjacently in the in-vivo soft portion 119E and the in-vitro soft portion 140E. FIG. 47

[0463] The second line sheath 162s that is inserted through the second left curved line 1621 and the second right curved line 162r is fixed by the fastener 163. Therefore, as shown in FIG. 9, the second left curved line 1621 and the second right curved line 162r are arranged on both sides in the LR direction in the second curved portion 114, but are arranged adjacently in the in-vivo soft portion 119E and the in-vitro soft portion 140E. FIG. 48

[0464] In the following description, without particularly distinguishing the first line sheath 161s and the second line sheath 162s, they will be referred to as "line sheaths 160s".

[0465] FIG. 49 FIG. 10 is a view showing two line sheaths 160s that are fixed.

[0466] ​​​​Two wire sheaths 160s are secured by a plurality of fasteners 163. The fasteners 163 securing the two wire sheaths 160s are arranged from the front end side (A1) to the base end side (A2) at a specified interval P.

[0467] The fastener 163 is formed in a ring shape and is configured along the circumferential direction C of the two wire sheaths 160s. Therefore, the fastener 163 secures the two wire sheaths 160s so that they do not separate in a direction perpendicular to the length direction A.

[0468] Fastener 163 is fixed to one of the two paired wire sheaths 160s (pair of sheaths) by riveting, brazing, or heat shrinking. On the other hand, fastener 163 is not fixed to the other of the two paired wire sheaths 160s (pair of sheaths). Therefore, the other wire sheath 160s (pair of sheaths) can move forward and backward relative to fastener 163 in the longitudinal direction A and rotate about the circumference direction C.

[0469] FIG. 49 It is a cross-sectional view of the curved internal soft part 119E and the external soft part 140E.

[0470] When the inner soft part 119E and the outer soft part 140E are bent, the pair of wire sheaths 160s (pair of sheaths) fixed by the fastener 163 become approximately bent. The bending shape of the two bent wires 160 inserted through the pair of wire sheaths 160s (pair of sheaths) is also approximately bent.

[0471] One side of the sheath is fixed to fastener 163, but the other side of the sheath is not fixed to fastener 163. Therefore, even if a difference in the inner and outer wheel diameters of the sheath occurs when the inner soft part 119E and the outer soft part 140E bend, the sheath 160s will not twist or deform because the other side of the sheath moves relative to fastener 163.

[0472] The two wires inserted through the sheath are a pair of opposing curved wires 160 (opposite wires) that bend the curved portion 112 in the UD or LR direction. Therefore, even when the opposing wires are inserted through the sheath and extend long from the insertion portion 110E to the inner flexible portion 119E and the outer flexible portion 140E of the drive device 200, the bending shape of the opposing wires is approximately the same. As a result, the drive controller 260 can easily estimate the tension (tension difference, tension ratio, etc.) of the opposing wires and easily bend the curved portion 112 accurately.

[0473] FIG. 49 This is a diagram showing the insertion part 110E inserted into the large intestine.

[0474] In particular, the sheath that penetrates the in-vivo soft portion 119E is desirably fixed by the fastener 163 at an interval P that matches the intended curved shape. The in-vivo soft portion 119E that penetrates into the large intestine passes through a large-curved region RB1 that is largely curved and a small-curved region RB2 that is less curved than the large-curved region RB1.

[0475] It is assumed that the sheath that is disposed in the large-curved region RB1 when treating the affected portion is desirably fixed by the fastener 163 at a narrow interval P. In the large-curved region RB1, the sheath can be limited from being largely curved, and the transmission efficiency of the opposing wires can be prevented from decreasing. In the case where the sheath is fixed by the fastener 163 at a wide interval P in the large-curved region RB1, the opposing wires respectively easily become different curved shapes. On the other hand, in the case where the sheath is fixed by the fastener 163 at a narrow interval P in the large-curved region RB1, the curved shapes of the opposing wires are similar to each other, and the tension of the opposing wires can be easily estimated.

[0476] It is assumed that the sheath that is disposed in the small-curved region RB2 when treating the affected portion is desirably fixed by the fastener 163 at a wider interval P. Since the sheath is not assumed to be largely curved in the small-curved region RB2, it is desirable to further widen the interval P to reduce the influence on the transmission of the opposing wires by the fastener 163 itself.

[0477] According to the electric endoscope system 1000E of the present embodiment, the observation or treatment using the endoscope 100E can be more effectively performed. Since the endoscope 100E is separated from the operation device 300, the surgeon S can independently operate the endoscope 100E and the operation device 300 without affecting each other.

[0478] With the separation of the driving device 200 from the operation device 300, the path of the curved line 160 of the endoscope 100E from the insertion portion 110E to the driving device 200 is sometimes lengthened, but the driving controller 260 can easily estimate the tension of the opposing wires (tension difference, tension ratio, etc.) and accurately bend the bending portion 112.

[0479] The fifth embodiment of the present application has been described above with reference to the drawings, but the specific structure is not limited to this embodiment, and design changes and the like within the scope of the gist of the present application are also included. Furthermore, the structural elements shown in the above-described embodiments and modified examples can be appropriately combined.

[0480] (Modified Example 5-1)

[0481] In the above embodiment, the bending portion 112 has the first bending portion 113 and the second bending portion 114 to have a bending function (a multi-stage bending function) of bending in two stages. However, the manner of the bending portion 112 is not limited to this. The bending portion 112 can also have only the second bending portion 114 without having the first bending portion 113. The bending portion 112 can also have a third bending portion to be able to bend in three stages.

[0482] (Modified Example 5-2)

[0483] In the above embodiment, one of the sheaths is fixed to the fastener 163, but the other of the sheaths is not fixed to the fastener 163. However, the manner of fixing the sheaths is not limited to this. It can also be that both of the sheaths are fixed to the fastener 163. Further, it can also be that neither of the sheaths is fixed to the fastener 163.

[0484] (Modified Example 5-3)

[0485] In the above embodiment, the wire sheath 160s that penetrates the in-vivo soft portion 119E and the in-vitro soft portion 140E is fixed by the fastener 163. However, the manner of fixing the wire sheath 160s is not limited to this. It can also be that only a part of the wire sheath 160s that penetrates the in-vivo soft portion 119E and the in-vitro soft portion 140E is fixed by the fastener 163.

[0486] (Sixth Embodiment)

[0487] In a case where the electric endoscope system is provided with a function such as the coordinated bending control mode M5, the cost is likely to be high, and thus the price of the electric endoscope system is likely to be high. Therefore, the user (hospital) can hesitate to introduce the electric endoscope system.

[0488] The sixth embodiment of the present application provides an electric endoscope system that is able to use a function such as the coordinated bending control mode M5 only when the function is needed, and generate information for billing or the like when the function can be used. By this, it is possible to reduce the cost when the user introduces the electric endoscope system. Hereinafter, the function that is the object of billing will be referred to as an additional function.

[0489] Reference Signs FIG. 26 A billing system 2000 including the electric endoscope system of the sixth embodiment will be described. FIG. 1 is a whole view of the billing system 2000 of the present embodiment.

[0490] [Billing System 2000]

[0491] As shown in FIG. 26 , the billing system 2000 has a billing server SV1, a hospital server SV2, and an electric endoscope group 2100.

[0492] [charging server SV1]

[0493] The charging server SV1 manages information for charging. The charging server SV1 is a computer that has a processor, a memory, a storage section capable of storing programs and data, and an input / output control section. The functions of the charging server SV1 are realized by the processor executing the programs. The functions of at least a part of the charging server SV1 can also be realized by a dedicated logic circuit.

[0494] The charging server SV1 and the hospital server SV2 implement communication with each other via an external network NW1 and an internal network NW2. The external network NW1 is, for example, the Internet. The internal network NW2 is, for example, a LAN (Local Area Network) constructed within a hospital. The charging server SV1 implements communication with the electric endoscope group 2100 via the external network NW1 and the internal network NW2, and receives information related to the use of the additional function. The charging server SV1 performs processing for charging based on the received information.

[0495] [charging server SV1]

[0496] The hospital server SV2 is included in a hospital internal system and manages electronic medical records and the like. The hospital server SV2 is a computer that has a processor, a memory, a storage section capable of storing programs and data, and an input / output control section. The functions of the hospital server SV2 are realized by the processor executing the programs. The functions of at least a part of the hospital server SV2 can also be realized by a dedicated logic circuit.

[0497] [electric endoscope group 2100]

[0498] The electric endoscope group 2100 has a plurality of electric endoscope systems. For example, the electric endoscope group 2100 has an electric endoscope system including the control device 600a and the endoscope 100a, an electric endoscope system including the control device 600b and the endoscope 100b, an electric endoscope system including the control device 600c and the endoscope 100c, and the endoscope 100d. The control device 600a and the endoscope 100a are used in the treatment room RM100, the control device 600b and the endoscope 100b are used in the treatment room RM101, the control device 600c and the endoscope 100c are used in the treatment room RM102. The endoscope 100d is not used.

[0499] The control device 600a, the control device 600b, and the control device 600c have the same structure as the control device 600B illustrated in FIG. 6. The endoscope 100a, the endoscope 100b, and the endoscope 100c have the same structure as the endoscope 100B illustrated in FIG. 7. FIG. 50 FIG. 51 ​The endoscope 100 shown has the same structure. The endoscope 100a is connected to the control device 600a. The endoscope 100a can also be connected to the control device 600b or the control device 600c. The endoscope 100b is connected to the control device 600b. The endoscope 100b can also be connected to the control device 600a or the control device 600c. The endoscope 100c is connected to the control device 600c. The endoscope 100c can also be connected to the control device 600a or the control device 600b. In the case of using the endoscope 100d, the endoscope 100d is connected to any one of the control device 600a, the control device 600b, and the control device 600c. In each of the electric endoscope systems, structures other than the control devices and the endoscopes are not shown.

[0500] Hereinafter, as one of the electric endoscope systems included in the electric endoscope group 2100, the electric endoscope system 1000B shown is used. FIG. 50

[0501] A hospital server SV2 and a hospital in-network to which the electric endoscope group 2100 is connected are not shown. A personal computer (PC) or the like connected to the hospital in-network is not shown.

[0502] The functions of the billing system 2000 are described. The sixth embodiment is not limited to the following example.

[0503] The drive controller 260B possessed by the drive device 200B detects the state of the switching switch 340B, and transmits state information indicating the state to the processor 561 of the image control device 500 possessed by the control device 600B. The processor 561 receives the state information from the drive controller 260B, and detects the bending mode of the bending portion 112 based on the state information. In the case where the bending mode is a mode in which the additional function is used, the processor 561 generates usage status information indicating the use of the additional function. The usage status information is billing information used for billing.

[0504] The electric endoscope system 1000B has two or more functions including a basic function and an additional function. For example, a mode in which the basic function is used is the analog single-bending control mode M4. For example, a mode in which the additional function is used is at least one of the first bending portion control mode Ml, the second bending portion control mode M2, the coordinated bending control mode M5, and the analog single-bending transition mode M6. As for which modes are included in the basic function and the additional function, the modes included in each function can be combined by setting, and the manufacturer can freely set the modes included in each function. The basic function is not a billing target, and the additional function is a billing target.

[0505] ​The processor 561 is communicably connected to the billing server SV1. The processor 561 outputs the generated usage status information to the input / output control section 564 of the image control device 500 possessed by the control device 600B. The input / output control section 564 has a communication circuit and is connected to the internal network NW2. The input / output control section 564 performs communication with the billing server SV1 via the internal network NW2 and the external network NW1, and transmits the usage status information to the billing server SV1. The billing server SV1 receives the usage status information from the input / output control section 564, and performs processing for billing based on the usage status information.

[0506] The processor 561 can also record a system log including the usage status information in the memory 562 of the image control device 500 possessed by the control device 600B. For example, the system log can be retrieved from the memory 562 by a worker who performs maintenance of the electric endoscope system 1000B at the time of performing the maintenance. In this case, the input / output control section 564 does not need to transmit the usage status information to the billing server SV1.

[0507] In a system in which the billing amount is decided based on only the number of times of use or the use time of the additional function, the surgeon S can speed up the surgical operation in order to reduce the number of times of use or the use time of the additional function. In the following example, even in a case where the additional function is used more than once in order to perform observation or treatment of one case, the billing amount is the same as that for one use. Therefore, the possibility that the surgeon S speeds up the surgical operation in order to reduce the billing amount decreases. Each case is associated with a patient. The treatment of the case can also include surgery.

[0508] It is possible to perform many observations or treatments of cases in one day. Furthermore, there are cases that require the additional function and cases that do not require the additional function, and it is necessary to accurately record the usage status of the additional function. During the period in which observation or treatment of one case is performed, the surgeon S can switch the power source of the electric endoscope system 1000B on and off. Alternatively, during the period in which observation or treatment of one case is performed, the surgeon S can remove the endoscope 100 and reassemble the endoscope 100, but the processor 561 has a function of detecting a change in the case and generating usage status information for each case without being affected by these matters.

[0509] The processor 561 generates a case identifier. One case identifier is assigned to one case. The case identifier is not repeated among a plurality of cases. The processor 561 associates the case identifier with the usage status information with each other, and records the case identifier and the usage status information in the memory 562.

[0510] The processor 561 is communicably connected with the hospital server SV2. The input-output control section 564 performs communication with the hospital server SV2 via the internal network NW2, receives a prescribed identifier that identifies a case. Alternatively, the input-output control section 564 acquires a prescribed identifier input to an input device (for example, a keyboard) not shown. The prescribed identifier is a patient ID, a date ID, or a check sheet ID, and the like, which are prepared in the hospital. The input-output control section 564 outputs the prescribed identifier to the processor 561. The processor 561 generates a case identifier based on the prescribed identifier, thereby acquiring the case identifier.

[0511] The processor 561 can detect a change in the case by detecting a change in the identifier provided from the hospital. By combining two or more identifiers, the processor 561 can accurately detect a change in the case. For example, in addition to using the above-described ID, an endoscope ID assigned to each endoscope 100 can be used. Sometimes, two or more different endoscopes 100 are used for the same patient. For example, an endoscope 100 for an upper gastrointestinal examination and an endoscope 100 for a lower gastrointestinal examination are different from each other. In a case where the patient ID does not change and the endoscope ID changes, the processor 561 can detect a change in the case. The use period of the identifier provided from the hospital can be set, and the identifier for which the use period has elapsed becomes invalid.

[0512] For example, after observation or treatment of one case is performed, cleaning of the endoscope 100 is performed. In a system that records a history of the cleaning, an identifier corresponding to the history can also be used.

[0513] By using the endoscope ID or the like in addition to the identifier provided from the hospital or setting the use period of the identifier provided from the hospital, improper use of the identifier provided from the hospital can be suppressed.

[0514] The billing method is decided based on the kind of contract made by the provider and the user of the motor-driven endoscope system 1000B. The processor 561 suppresses the performance of communication via the internal network NW2 during the performance of observation or treatment.

[0515] For example, the kind of contract includes a comprehensive contract, a pay-as-you-go contract, and a long-term contract. In the comprehensive contract, the fee for the contract period is fixed regardless of whether the additional function is used. In the pay-as-you-go contract, a billing amount is generated for the use of the additional function in a case where the additional function is used for one case. In the case where the contract period of the comprehensive contract or the pay-as-you-go contract ends, the user cannot use the additional function. In the long-term contract, a billing amount is not generated even if the additional function is used. Contract information indicating the kind of contract is recorded in the storage 562.

[0516] The user who has concluded a long-term contract can also attach a hardware encryption lock (dongle) to the video control device 500. The processor 561 can also detect the hardware encryption lock via the input / output control section 564, and determine that the type of contract is a long-term contract. In the case of a long-term contract, the usage status information can also be recorded in the system log.

[0517] The electric endoscope system 1000B described above outputs billing information corresponding to the usage status of the user using the endoscope 100. The processor 561 acquires a case identifier corresponding to a case in which the endoscope 100 is used. The processor 561 detects a state in which a function that is a billing object is used. In a case where billing information associated with the case identifier is generated, the processor 561 does not generate new billing information associated with the case identifier. In a case where the state in which the function that is the billing object is used is detected and billing information associated with the case identifier is not generated, the processor 561 newly generates and outputs billing information associated with the case identifier.

[0518] Reference FIG. 51 and FIG. 50 , the processing for billing is described. FIG. 50 and FIG. 50 are flowcharts showing steps of the processing performed by the processor 561.

[0519] When the electric endoscope system 1000B is started, the processor 561 starts the processing shown in FIG. 50 . The processor 561 refers to the contract information recorded in the storage 562, and confirms the type of contract (step S100). The processor 561 can also cause the input / output control section 564 to perform communication with the hospital server SV2, and receive the contract information from the hospital server SV2.

[0520] In step S100, in a case where the type of contract is a pay-as-you-go contract, step S105 is executed. In step S100, in a case where the type of contract is a comprehensive contract or a long-term contract, the processing shown in FIG. 50 ends.

[0521] In step S100, in a case where the type of contract is a pay-as-you-go contract, the processor 561 causes the input / output control section 564 to perform communication with the hospital server SV2, and receives a prescribed identifier A provided from the hospital from the hospital server SV2. The processor 561 acquires the identifier A received by the input / output control section 564 from the input / output control section 564 (step S105).

[0522] In step S100, in the case where the type of the contract is a pay-as-you-go contract, the display device 900 can also display a screen for causing the surgeon S to confirm the use of the license. In the case where the surgeon S permits the use of the additional function, step S105 can also be executed. In the case where the surgeon S does not permit the use of the additional function, only the basic function can be used.

[0523] After the identifier A is acquired in step S105, the processor 561 calculates a hash value h(A) by applying the identifier A to a hash function h(x). By using a non-reversible transformation function as the hash function, even if the information inherent to the hospital side is used as the identifier A, the information is protected. The processor 561 refers to the hash values Xh recorded in the memory 562 to determine whether the hash values Xh and the hash value h(A) are the same. In the case where two or more hash values Xh are recorded in the memory 562, the processor 561 executes this determination for each hash value Xh (step S110).

[0524] In the case where the additional function is used, the hash value Xh is recorded in the memory 562 in step S120 described later. The processor 561 determines whether the hash value Xh recorded in the memory 562 in the past and the hash value h(A) are the same by executing step S110. In the case where the hash value Xh and the hash value h(A) are the same, the processor 561 can determine that the same case as in the past is being processed. In this case, the information required for billing is already recorded in the memory 562. Therefore, the processor 561 does not need to record the information required for billing in the memory 562 again. On the other hand, in the case where the hash value Xh and the hash value h(A) are not the same, the processor 561 can determine that a case different from the past is being processed. In this case, the information required for billing is not recorded in the memory 562. Therefore, in the case where the additional function is used, the processor 561 records the information required for billing in the memory 562 in step S120 described later.

[0525] In step S110, in the case where one hash value Xh and the hash value h(A) are the same, FIG. 50 The processing illustrated in the drawing ends. In step S110, in the case where all the hash values Xh and the hash value h(A) are different, step S115 is executed.

[0526] In step S110, in the case where all the hash values Xh and the hash value h(A) are different, the processor 561 detects the bending mode of the bending portion 112 on the basis of the state information received from the drive controller 260B. The processor 561 determines whether the additional function is used on the basis of the detected bending mode (step S115).

[0527] In a case where the additional function is used in step S115, step S120 is executed. In a case where the additional function is not used in step S115, step S125 is executed.

[0528] In a case where the additional function is used in step S115, the processor 561 increases the number of uses N by 1. Further, the processor 561 processes the hash value h(A) of the identifier A as a new hash value Xh. The processor 561 associates the number of uses N and the hash value Xh with each other, and records the combination [N, Xh] of the number of uses N and the hash value Xh in the memory 562 (step S120).

[0529] The number of uses N is usage status information indicating the number of times the additional function is used. The initial value of the number of uses N is 0. The hash value Xh is a case identifier corresponding to the identifier A. The processor 561 acquires the case identifier by calculating the hash value Xh corresponding to the identifier A (ID) output from the hospital server SV2. The case identifier is not limited to the hash value. The hash value Xh corresponding to the identifier A is different from all the hash values Xh recorded in the memory 562 at the time of execution of step S110. The processor 561 records the combination [N, Xh] including the new case identifier different from the case identifiers recorded in the memory 562 in the memory 562. The combination [N, Xh] indicates that the additional function is used for the case corresponding to the identifier A. The combination [N, Xh] functions as billing information. When the combination [N, Xh] is recorded in the memory 562 in step S120, FIG. 50 The processing illustrated in the drawing ends.

[0530] In a case where the additional function is not used in step S115, the processor 561 determines whether observation or treatment for one case ends (step S125).

[0531] In a case where observation or treatment for one case ends in step S125, FIG. 50 The processing illustrated in the drawing ends. In a case where observation or treatment for one case does not end in step S125, step S115 is executed.

[0532] In a case where the additional function is not used at all during observation or treatment for one case, FIG. 51 The processing illustrated in the drawing ends.

[0533] In a case where 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. In a case where the additional function is used more than twice for one case, the combination [N, Xh] is not updated.

[0534] For example, after the additional function is used for one case, the surgeon S sometimes sets the power of the electric endoscope system 1000B to off, and then sets the power of the electric endoscope system 1000B to on again. After the power becomes on, the processor 561 executes the processing shown in FIG. 12 again. If the case does not change during the change in the state of the power, the processor 561 determines that one hash value Xh is the same as the hash value h(A) in step S110. In this case, the combination [N, Xh] is not updated, and therefore the number of uses of the additional function does not increase, and the processor 561 can generate the use status information for each case. FIG. 50 The processing shown in FIG. 12 is executed. If the case does not change during the change in the state of the power, the processor 561 determines that one hash value Xh is the same as the hash value h(A) in step S110. In this case, the combination [N, Xh] is not updated, and therefore the number of uses of the additional function does not increase, and the processor 561 can generate the use status information for each case.

[0535] When the combination [N, Xh] associated with the case identifier is generated, the processor 561 records the generated combination [N, Xh] in the memory 562. In the case where the combination [N, Xh] associated with the case identifier is recorded in the memory 562, the processor 561 does not generate a new combination [N, Xh] associated with the case identifier. In the case where the state of using the additional function is detected and the combination [N, Xh] associated with the case identifier is not recorded in the memory 562, the processor 561 newly generates the combination [N, Xh] associated with the case identifier.

[0536] The processor 561 can also detect the state of using only the basic function. In the case where this state is detected and the combination [N, Xh] associated with the case identifier is recorded in the memory 562, the processor 561 does not need to generate a new combination [N, Xh] associated with the case identifier.

[0537] In the example shown in FIG. 12, the number of uses N is not recorded in the memory 562 in the case where the type of the contract is a comprehensive contract or a long-term contract. In order for the provider of the electric endoscope system 1000B to know the use status of the additional function in the comprehensive contract or the long-term contract, the number of uses of the additional function in the comprehensive contract or the long-term contract can also be recorded in the memory 562. In this case, the billing amount for the use of the additional function is not generated. FIG. 51

[0538] FIG. 51 The processing executed in the case where the observation or the treatment for one case ends is shown. For example, after the processing shown in FIG. 13 ends, the processing shown in FIG. 14 is executed. FIG. 50 After the processing shown in FIG. 14 ends, the processing shown in FIG. 15 is executed. FIG. 51

[0539] ​​The processor 561 generates mode use information indicating whether or not the additional function is used. In a case where the additional function is used, the mode use information also indicates the kind of the additional function used. The processor 561 causes the input-output control section 564 to perform communication with the hospital server SV2, and causes the image data and the mode use information acquired from the endoscope 100 to be transmitted to the hospital server SV2 (step S200). The processor 561 can also cause the input-output control section 564 to transmit the mode use information to the hospital server SV2 together with a report of observation or diagnosis.

[0540] The hospital server SV2 receives the image data and the mode use information from the input-output control section 564. The hospital server SV2 displays the mode use information on a display device not shown, for example. A person concerned with the hospital can confirm the use status of the additional function.

[0541] After the image data and the mode use information are transmitted in step S200, the processor 561 generates use status information based on the combination [N, Xh] recorded in the memory 562. The use status information indicates that the additional function is used. The use status information can also be information indicating the number of uses N. The processor 561 causes the input-output control section 564 to perform communication with the billing server SV1, and transmits the system maintenance information and the use status information to the billing server SV1 (step S205).

[0542] In a case where the number of uses N is 0, the processor 561 does not need to transmit the use status information to the billing server SV1. In a case where the number of uses N is 0, the processor 561 can also transmit use status information indicating that the additional function is not used to the billing server SV1.

[0543] The billing server SV1 receives the system maintenance information and the use status information from the input-output control section 564. The billing server SV1 performs processing for billing based on the use status information. For example, in a case where the kind of contract is a pay-as-you-go contract, the billing server SV1 calculates the billing amount based on the use status of the additional function. In a case where the additional function is used for M (M is an integer of 1 or more) cases, the billing server SV1 calculates the billing amount corresponding to the use of the additional function M times.

[0544] The processor 561 can also not transmit (output) the billing information to the billing server SV1 (external server) during observation or treatment of a case corresponding to the case identifier. The processor 561 can also transmit (output) the billing information to the billing server SV1 at a point in time at which observation or treatment of a case corresponding to the case identifier ends.

[0545] In a system in which the operator of maintenance acquires the system log from the memory 562, the processor 561 does not need to performFIG. 50 The processing shown in

[0546] The processor 561 can also add 1 to the number of uses each time the additional function is used for one case. The processor 561 can also generate use status information indicating the number of uses for each case.

[0547] The processor 561 can also calculate the time during which the additional function is used in the case where the additional function is used. The processor 561 can also generate use status information indicating the time. For example, the processor 561 calculates the cumulative time during which the additional function is used in observation or treatment of the case corresponding to the case identifier. The cumulative time is the total of the times during which the additional function is used in observation or treatment of one case. For example, in the case where the additional function is used during a first period and a second period that are different from each other, the processor 561 calculates the cumulative time by adding 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 use status information.

[0548] 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 can also be a diagnosis mode using artificial intelligence (AI). The mode in which the additional function is used can also be a navigation mode.

[0549] In the example described above, the processor 561 generates information indicating the use of the additional function for each case. The processor 561 can also generate information indicating the use of the additional function regardless of cases.

[0550] In the example described above, the processor 561 performs the processing shown in FIG. 51 and FIG. 50 The drive controller 260B of the control device 600B that has the drive device 200B can also perform the processing shown in FIG. 50 and FIG. 52

[0551] 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, for example. The program can also be transmitted to the control device 600B from a computer that holds 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 that has a function of transmitting information. The medium that has a function of transmitting information includes a network (communication network) such as the Internet and a communication line (communication wire) such as a telephone line. The program described above can also realize a part of the functions described above. Furthermore, the program described above can also be a differential file (differential program). The functions described above can also be realized by a combination of a program already recorded in a computer and a differential program.

[0552] ​In the electric endoscope system 1000B of the sixth embodiment, hospitals can use additional functions when performing difficult surgical procedures, thereby reducing the cost of introducing the electric endoscope system 1000B. For example, this cost can be equivalent to the cost of introducing a conventional endoscope system.

[0553] By using the add-on feature, hospitals can shorten the time required for time-consuming surgical procedures. For example, hospitals can also use the add-on feature on days with a high volume of cases. This allows hospitals to flexibly respond to changes in case volume, improving operational efficiency.

[0554] Even if the additional function is used more than twice for the observation or treatment of a single case, the billing amount does not increase based on the number of uses. FIG. 52 In the process shown, a specified identifier was obtained. This identifier is... FIG. 1 The identifier is used in the process shown, but after the process is completed, the memory 562 does not need to store the identifier. 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 identifier provided by the hospital with the endoscope ID, the usage status of the additional functions can be accurately detected.

[0555] In addition, in this embodiment, previously stored usage information can also be used to provide useful information to the surgeon S operating the electric endoscope system 1000B.

[0556] Surgeon S needs to select the function to use from the multiple functions available in the electric endoscope system 1000B, based on the needs of the surgeon.

[0557] In addition to the "First Bending Control Mode (Front-End Side Bending Control Mode) M1" and the "Second Bending Control Mode (Base-End Side Bending Control Mode) M2", the system also has a "Coordinated Control Mode M3" that coordinates the control of the first bending portion 113 and the second bending portion 114. The bending modes in the Coordinated Control Mode M3 are classified as the following bending modes: "Simulated Single Bending Control Mode M4 (First Mode)" in which the bending portion 112 bends as a single bending portion; "Coordinated Bending Control Mode M5 (Second Mode)" in which the first bending portion 113 and the second bending portion 114 bend in coordination; and "Simulated Single Bending Transition Mode M6 (Third Mode)".

[0558] The hospital server SV2 stores patient information (electronic medical record) of a plurality of patients. In the patient information, in addition to the case identifier generated by the processor 561, biological information and case information are included. In the patient information, as the biological information, age, sex, height, weight, body type, blood pressure, and past operation history of the patient are included. In the patient information, as the case information, the classification result of the lesion, the position of the lesion, and the size of the lesion are included.

[0559] The hospital server SV2 stores usage information in association with the case identifier included in the patient information. In the usage information, in addition to the billing information used for billing, the identification information of the operating surgeon S who is in charge of the case, the type of the surgical operation (medical action) performed in the case, the type of the bending mode used in the surgical operation, and information indicating the time when the bending mode was used are included.

[0560] The identification information of the operating surgeon S related to the case and the type of the surgical operation (medical action) performed in the case are input to the input / output control section 564 from an unillustrated input device (for example, a keyboard) as the usage information.

[0561] The operating surgeon S operates the switch 340 to select the bending mode. The switch 340 is a selection unit by which the operating surgeon S can explicitly select the bending mode related to the endoscope in a state where the operating device 300 is not released from the hand during the operation. In the display device 900, information for confirming whether or not the newly selected bending mode is used is prompted, and the operating surgeon S inputs information indicating the agreement by using various buttons 352 and the like. Thus, the bending mode related to the endoscope is switched to the newly selected bending mode by the operation of the switch 340. Thus, the selection of the bending mode becomes two stages, and thus, misuse and misbilling can be prevented.

[0562] The drive controller 260B of the drive device 200B detects the state of the switch 340B and transmits state information (information of the bending mode) indicating the state to the processor 561 of the image control device 500 of the control device 600B. The processor 561 receives the state information from the drive controller 260B, detects the bending mode of the bending portion 112 based on the state information, and controls the bending. The processor 561 generates usage information indicating the used bending mode.

[0563] The processor 561 is communicably connected with the hospital server SV2, and thus, the case identifier is transmitted to the hospital server SV2 in association with the use status information. The hospital server SV2 receives the case identifier and the use status information from the input / output control section 564, and stores the case identifier and the use status information in association with the stored patient information.

[0564] In a case where the surgeon S reviews the stored use status information, the case identifier of the case that the surgeon S wants to review is input from an unillustrated input device to the input / output control section 564.

[0565] The hospital server SV2 receives the case identifier input to the input / output control section 564. The hospital server SV2 determines the use status information from the stored plurality of patient information based on the case identifier. That is, the hospital server SV2 determines the use status information with which the same case identifier as the case identifier input to the input / output control section 564 is associated. The hospital server SV2 transmits the determined use status information to the input / output control section 564.

[0566] The display device 900 displays the use status information received by the input / output control section 564.

[0567] In the present embodiment, the surgeon S can be provided with useful information that the surgeon S can review the surgical operation performed by himself or herself.

[0568] In addition thereto, the kind of the bending mode used in the case can be stored in correspondence with the time during which the bending mode was used, and information indicating which bending mode was used at which point in time and for how long can be prompted as useful information. Thereby, the surgeon S can review the surgical operation, and further improvement of the surgical operation can be realized. Further, this is effective not only for review of the surgical operation, but also for investigation in the event of an accident.

[0569] Generally, a staff member such as a nurse records the flow of the surgery and the medicaments used and the like during the surgery. In the present embodiment, information indicating the use status of the bending mode used by the surgeon S without cooperation with the staff member can be automatically stored, and thus, the recording effort of the nurse and the staff member can be reduced.

[0570] As explained above, by effectively utilizing the use status information generated by the electric endoscope system, contribution to the effectiveness of the surgical operation, improvement of the performance, and stabilization of the cost and the like can be facilitated.

[0571] (SEVENTH EMBODIMENT)

[0572] The electric endoscope system of the seventh embodiment of the present application 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 manner that the surgeon S can easily grasp the bending direction. In a case where the coordinated bending control mode M5 or the like is used, the surgeon S can have difficulty in grasping the bending direction by 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 to appropriately display the three-dimensional image.

[0573] The seventh embodiment provides an electric endoscope system that displays a three-dimensional image for enabling the surgeon S to easily grasp the bending direction.

[0574] Reference FIG. 53 The electric endoscope system 1000G of the seventh embodiment will be described. In the following description, the same reference numerals are annotated for structures common to the structures already described, and the repeated description is omitted.

[0575] As FIG. 53 shown, the electric endoscope system 1000G is a medical system that performs observation and treatment of the inside of a patient P lying on a surgical table T. The electric endoscope system 1000G is provided with an endoscope 100, a driving device 200B, an operation device 300B, a treatment instrument 400, an image control device 500 (refer to FIG. 54 ), a camera 570, and a display device 900.

[0576] The camera 570 generates an image of an imaging field of view including the surgeon S, the endoscope 100, and the display device 900. The camera 570 is connected to the input / output control section 564 of the image control device 500. The camera 570 transmits the generated image to the input / output control section 564. Two or more cameras can be provided.

[0577] The input / output control section 564 performs communication with the camera 570, and receives the image. The processor 561 of the image control device 500 acquires the image received by the input / output control section 564 from the input / output control section 564. The processor 561 processes the image, and detects a first direction and a second direction. The first direction is a direction related to the endoscope 100. The second direction is a direction related to the display device 900. The processor 561 determines the direction of the line of sight for displaying a three-dimensional image representing the shape of the bending portion 112, based on the first direction and the second direction.

[0578] The drive controller 260B of the drive device 200B communicates with the input / output control section 564, and transmits the bending amount of the UD direction of the first bending section 113, the bending amount of the LR direction of the first bending section 113, the bending amount of the UD direction of the second bending section 114, and the bending amount of the LR direction of the second bending section 114. The input / output control section 564 receives each of the bending amounts and outputs to the processor 561. The processor 561 generates a three-dimensional image of the endoscope 100 viewed in the decided direction based on each of the bending amounts. The processor 561 displays the three-dimensional image on the display device 900.

[0579] Referring to FIG. 55 , the processing for displaying a three-dimensional image will be described. FIG. 54 is a flowchart showing the steps of the processing performed by the processor 561.

[0580] The processor 561 causes the input / output control section 564 to communicate with the camera 570, and receives an image from the camera 570. The processor 561 acquires the image received by the input / output control section 564 from the input / output control section 564 (step S300).

[0581] After the image is acquired 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 inclination of the endoscope 100 using a method of object detection or three-dimensional measurement. Further, the processor 561 detects the second direction by detecting the orientation of the display device 900.

[0582] FIG. 55 and FIG. 54 is a diagram showing the positional relationship of the endoscope 100 and the display device 900.

[0583] In FIG. 55 and FIG. 54 , the first direction DR1 and the 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. In the example shown in FIG. 55 and FIG. 54 , the second direction DR2 is a direction parallel to the horizontal plane and perpendicular to the screen of the display device 900.

[0584] In the example shown in FIG. 55 , the second direction DR2 is close to a direction parallel to the first direction DR1. In the example shown in FIG. 56 , the second direction DR2 is close to a direction perpendicular to the first direction DR1.

[0585] The processor 561 need not accurately detect the first direction and the second direction. The processor 561 detects the first direction and the second direction with a precision sufficient to distinguish FIG. 57 the state shown in FIG. 6B and FIG. 56 the state shown in FIG. 6C.

[0586] After detecting the first direction and the second direction in step S305, the processor 561 decides the direction of the line of sight for displaying the three-dimensional image based on the first direction and the second direction (step S310).

[0587] For example, the viewpoint for displaying the three-dimensional image is set at a position where at least the distal end portion 111 and the curved portion 112 are included in the field of view. In FIG. 57 the example shown in FIG. 6B, the second direction DR2 is close to a direction parallel to the insertion direction of the endoscope 100, and therefore the processor 561 sets the direction of the line of sight as a direction from the in-vivo soft portion 119 side toward the distal end portion 111 side (the length direction A of the endoscope 100). In FIG. 53 the example shown in FIG. 6C, 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 as a direction intersecting the length direction A of the endoscope 100.

[0588] After deciding the direction of the line of sight in step S310, the processor 561 causes the input-output control portion 564 to perform communication with the drive controller 260B, and acquires the respective bending amounts of the first curved portion 113 and the respective bending amounts of the second curved portion 114 from the input-output control portion 564 (step S315).

[0589] After acquiring the respective bending amounts of the first curved portion 113 and the respective bending amounts of the second curved portion 114 in step S315, the processor 561 generates a three-dimensional image of the endoscope 100 observed in the direction decided in step S310 based on the respective bending amounts (step S320).

[0590] 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 portion 564. The display device 900 displays the three-dimensional image (step S325).

[0591] FIG. 53 and FIG. 53 An example of a three-dimensional image displayed by the display device 900 is shown. In FIG. 58 the example shown in FIG. 7A, the three-dimensional image IMG1 is displayed on the screen 902 of the display device 900. In FIG. 59In the example shown, the three-dimensional image IMG2 is displayed on screen 902 of the display device 900. The three-dimensional images IMG1 and IMG2 represent the state of the curved portion 112 as observed in a direction close to the line of sight of the surgeon S. Therefore, the surgeon S can easily grasp the direction of the curvature.

[0592] The processor 561 can also be used with FIG. 60 Step S315 is executed at different time points as shown to obtain the bending amounts of the first curved portion 113 and the second curved portion 114. For example, the processor 561 may also execute step S315 before executing any one of steps S300, S305, and S310.

[0593] The drive controller 260B of the drive unit 200B can also communicate with the input / output control unit 564 to send the rotation angle of the cylindrical member 121. The input / output control unit 564 can also receive the rotation angle and output it to the processor 561. The processor 561 can also generate a three-dimensional image of the endoscope 100 based on each bending amount and rotation angle.

[0594] In the example above, processor 561 executes... FIG. 58 The process shown can also be performed by the drive controller 260B of the drive unit 200B. FIG. 59 The processing is shown. The processor 561 or the drive controller 260B can also read in a program and execute the read program.

[0595] In the example above, one display device is configured, but two display devices can also be configured. For example, one display device could display images obtained by the endoscope, while the other display device could display a three-dimensional image. In this case, it would be desirable to use the display device that displays the three-dimensional image to determine the direction of the surgeon S's line of sight.

[0596] In the example above, the first and second directions are detected by camera 570, but the direction of the line of sight can also be set manually without using a camera.

[0597] Another method for the processor 561 to determine the direction of the gaze in step S310 will be described. In the following method, the second direction is related to the direction of the surgeon S's gaze and varies depending on the positional relationship between the display device 900 and the surgeon S.

[0598] One or more cameras 570 are positioned to capture the surgeon S, endoscope 100, and display device 900 within the camera's field of view. Alternatively, one or more cameras 570 are positioned on the display device 900 and fixed in a position that allows the surgeon S and endoscope 100 to be captured within the camera's field of view.

[0599] The processor 561 detects a first direction corresponding to the tilt of the endoscope 100 using the same method as described above. Furthermore, the processor 561 detects a second direction as the direction from the surgeon S toward the display device 900 using object detection or three-dimensional measurement techniques.

[0600] FIG. 60 , FIG. 58 as well as FIG. 59 This is a diagram showing the positional relationship between the surgeon S, the endoscope 100, and the display device 900.

[0601] exist FIG. 60 , FIG. 58 as well as FIG. 59 The diagram illustrates a first direction DR1 and a second direction DR2. For example, the first direction DR1 is the direction in which the endoscope 100 is inserted into the lumen of the patient P. The second direction DR2 is related to the direction of the surgeon S's line of sight. FIG. 60 , FIG. 61 as well as FIG. 62 In the example shown, the second direction DR2 is the direction from the surgeon's position S toward the display device 900. For example, the surgeon's position S is the surgeon's viewpoint position. For example, the display device 900 is the center position of the screen displayed on the display device 900.

[0602] exist FIG. 63 In the example shown, the second direction DR2 is approximately parallel to the first direction DR1. FIG. 61 and FIG. 63 In the examples shown, the second direction DR2 is different from the first direction DR1.

[0603] FIG. 62 , FIG. 58 as well as FIG. 59 This is a diagram showing the relationship between the first direction DR1 and the second direction DR2. FIG. 60 In the example shown, the first direction DR1 is the same as the second direction DR2. FIGS. 64-67 The angle ANG2 shown is... FIG. 64 The angle ANG1 shown is larger. Angles ANG1 and ANG2 represent the angles between the first direction DR1 and the second direction DR2. The processor 561 determines the direction of the line of sight in such a way that the angle between the length direction A (major 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.

[0604] FIG. 65 The image shown is IMG11. FIG. 64The image IMG12 shown and FIG. 65 The image IMG13 shown is an example of a three-dimensional image displayed by the display device 900. The direction of the endoscope 100 in the three-dimensional image displayed by the display device 900 differs depending on the positional relationship between the display device 900 and the surgeon S. Thus, the direction of the endoscope 100 in the three-dimensional image displayed by the display device 900 differs.

[0605] The processor 561 can also display the current value of the amount of bending and the maximum value (limit value) of the amount of bending in 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 in the display device 900.

[0606] FIG. 65 is a diagram showing an example of an image for displaying the current value and the maximum value.

[0607] FIG. 64 The first example is shown. The measuring instruments MT1, MT2, MT3, and MT4 are displayed in the display device 900. Each of the measuring instruments is in a circular shape. The measuring instrument MT1 shows the amount of bending of the first bending portion 113 in the UD direction. The angle of the needle ND1 of the measuring instrument MT1 indicates the current value of the amount of bending. The measuring instrument MT2 shows the amount of bending of the first bending portion 113 in the LR direction. The angle of the needle ND2 of the measuring instrument MT2 indicates the current value of the amount of bending. The measuring instrument MT3 shows the amount of bending of the second bending portion 114 in the UD direction. The angle of the needle ND3 of the measuring instrument MT3 indicates the current value of the amount of bending. The measuring instrument MT4 shows the amount of bending of the second bending portion 114 in the LR direction. The angle of the needle ND4 of the measuring instrument MT4 indicates the current value of the amount of bending. The end of the range displayed by the needle ND1 or the needle ND3 indicates the maximum value of the amount of bending in the UD direction. The end of the range displayed by the needle ND2 or the needle ND4 indicates the maximum value of the amount of bending in the LR direction.

[0608] FIG. 66A second example is shown. The measuring instrument MT5 and the measuring instrument MT6 are displayed in the display device 900. The measuring instrument MT5 and the measuring instrument MT6 are circular. The measuring instrument MT5 includes a display bar BR1 and a display bar BR2. The display bar BR1 shows the amount of bending of the first bending portion 113 in the UD direction. The angle AG1 of the display bar BR1 indicates the current value of the amount of bending. The display bar BR2 shows the amount of bending of the first bending portion 113 in the LR direction. The angle AG2 of the display bar BR2 indicates the current value of the amount of bending. The measuring instrument MT6 includes a display bar BR3 and a display bar BR4. The display bar BR3 shows the amount of bending of the second bending portion 114 in the UD direction. The angle AG3 of the display bar BR3 indicates the current value of the amount of bending. The display bar BR4 shows the amount of bending of the second bending portion 114 in the LR direction. The angle AG4 of the display bar BR4 indicates the current value of the amount of bending. The end of the range shown by the display bar BR1 or the display bar BR3 indicates the maximum value of the amount of bending in the UD direction. The end of the range shown by the display bar BR2 or the display bar BR4 indicates the maximum value of the amount of bending in the LR direction.

[0609] In FIG. 67 or FIG. 66 In the example shown, the current value of the amount of bending and the maximum value of the amount of bending are displayed as angles. Thus, the surgeon S easily understands the current value of the amount of bending and the maximum value of the amount of bending. In FIG. 67 In the example shown, the amount of bending in the UD direction and the amount of bending in the LR direction are displayed by one measuring instrument. Thus, compared with the example shown in FIG. 66 In the example shown, the amount of bending in the UD direction and the amount of bending in the LR direction are displayed by one measuring instrument. Thus, compared with the example shown in

[0610] FIGS. 68-70 A third example is shown. Data bars DB1, DB2, DB3, and DB4 are displayed in the display device 900. Each data bar is rod-shaped. The data bar DB1 shows the amount of bending of the first bending portion 113 in the UD direction. The data bar DB2 shows the amount of bending of the first bending portion 113 in the LR direction. The data bar DB3 shows the amount of bending of the second bending portion 114 in the UD direction. The data bar DB4 shows the amount of bending of the second bending portion 114 in the LR direction. The end of the range shown by the data bar DB1 or the data bar DB3 indicates the maximum value of the amount of bending in the UD direction. The end of the range shown by the data bar DB2 or the data bar DB4 indicates the maximum value of the amount of bending in the LR direction.

[0611] FIG. 68A fourth example is shown. Data bars DB5, DB6, DB7, and DB8 are displayed in the display device 900. Each data bar is rod-shaped. The data bar DB5 shows the bending amount of the first bending portion 113 in the UD direction. The data bar DB6 shows the bending amount of the first bending portion 113 in the LR direction. The data bar DB7 shows the bending amount of the second bending portion 114 in the UD direction. The data bar DB8 shows the bending amount of the second bending portion 114 in the LR direction. The end of the range displayed by the data bar DB5 or DB7 indicates the maximum value of the bending amount in the UD direction. The end of the range displayed by the data bar DB6 or DB8 indicates the maximum value of the bending amount in the LR direction.

[0612] In FIG. 69 or FIG. 68 the example shown, the surgical physician S easily understands the observation method of each data bar, and the area of the screen required for display is saved. In FIG. 68 the example shown, the bending amount in the UD direction is displayed by a data bar extending in the up-down direction, and the bending amount in the LR direction is displayed by a data bar extending in the left-right direction. Therefore, compared with FIG. 68 the example shown, the surgical physician S easily grasps the bending state.

[0613] The electric endoscope system 1000G of the seventh embodiment displays a three-dimensional image showing the state of the bending portion 112 observed in a direction close to the direction of the line of sight of the surgical physician S in the display device 900. Therefore, the surgical physician S can easily grasp the bending direction.

[0614] The electric endoscope system 1000G displays the current value of the bending amount and the maximum value of the bending amount in the display device 900. Therefore, the surgical physician S can grasp the current value of the bending amount and the maximum value of the bending amount.

[0615] (Eighth Embodiment)

[0616] Referring to FIG. 69 , the electric endoscope system 1000H of the eighth embodiment of the present application will be described. In the following description, for structures common to those already described, the same reference numerals are assigned and repeated description is omitted. FIG. 70 is a general view of the electric endoscope system 1000H of the present embodiment. FIGS. 71-76 is a plan view of the electric endoscope system 1000H.

[0617] [Electric Endoscope System 1000H]

[0618] As FIG. 71As shown, the electric endoscope system 1000H is a medical system for observing and treating the body of a patient P lying horizontally on an operating table T. The electric endoscope system 1000H includes an endoscope 100H, a drive unit 200, an operating unit 300, a treatment instrument 400, an image control unit 500, a support unit 700, an observation unit 800, and a display unit 900.

[0619] [Endoscope 100H]

[0620] like FIG. 71 As shown, the endoscope 100H includes an insertion part 110H, a connecting part 120, an external flexible part 140, a loading and unloading part 150H, a curved wire 160, and an internal object 170. The insertion part 110H, the connecting part 120, the external flexible part 140, and the loading and unloading part 150H are connected sequentially from the front end side.

[0621] [Insertion section 110H]

[0622] The only difference between the insertion part 110H and the insertion part 110 of the first embodiment is that a magnetic coil (not shown) is built in along the length direction A. The magnetic coil is installed in a spiral shape, for example, along the inner circumferential surface of the internal path 101 of the insertion part 110H.

[0623] [Loading and Unloading Section 150H]

[0624] like FIG. 72 As shown, in addition to the first loading / unloading unit 1501 mounted on the drive unit 200 and the second loading / unloading unit 1502 mounted on the image control unit 500, the loading / unloading position attitude sensor 1504 is also provided in the loading / unloading unit 150H.

[0625] The loading / unloading position and attitude sensor 1504 is a sensor that detects the position and attitude of the base end of the connected external flexible part 140. For example, the loading / unloading position and attitude sensor 1504 detects the position of the base end of the external flexible part 140 relative to the control device 600, and the attitude of the base end of the external flexible part 140. The detection results of the loading / unloading position and attitude sensor 1504 are acquired by the main controller 560.

[0626] [Support device 700]

[0627] The support device 700 is a device that supports the endoscope 100H so that it can move. The support device 700 has a base 710, an arm 720, and an endoscope support portion 730.

[0628] The base 710 is a long member and is disposed on the floor. The base 710 extends to a position higher than the operating table T. The arm 720 is a long member, and one end thereof is connected to the front end of the base 710. The arm 720 is connected to the base 710, for example, by a two-degree-of-freedom joint, and the other end thereof is movable in the length direction A of the endoscope 100H and in the vertical direction (the direction in which the base 710 extends).

[0629] The endoscope support portion 730 has a support portion main body 731 that supports the extracorporeal flexible portion 140 of the endoscope 100H and an endoscope position / posture sensor 732. The support portion main body 731 is connected to the other end of the arm 720 in a manner such that it is rotatable about the length axis of the arm 720. The support portion main body 731 is substantially cylindrical and is detachably attached to the outer peripheral portion of the extracorporeal flexible portion 140. In the present embodiment, the endoscope support portion 730 is attached near the front end of the extracorporeal flexible portion 140.

[0630] The endoscope position / posture sensor 732 is a sensor that detects the position and posture of the extracorporeal flexible portion 140 that is supported. The endoscope position / posture sensor 732 detects, for example, the position of the vicinity of the front end of the extracorporeal flexible portion 140 with respect to the control device 600, the posture of the vicinity of the front end of the extracorporeal flexible portion 140, and the like. The detection result of the endoscope position / posture sensor 732 is acquired by the main controller 560 via the transmission cable 701.

[0631] The arm 720 does not move with respect to the base 710 as long as a prescribed or greater force is not applied thereto. Also, the endoscope support portion 730 does not rotate with respect to the arm 720 as long as a prescribed or greater force is not applied thereto. Therefore, for example, even in a case where the surgeon S moves the right hand R away from the extracorporeal flexible portion 119 in order to manipulate the treatment instrument 400, the position and posture of the extracorporeal flexible portion 140 that is supported by the support device 700 do not change.

[0632] [Observation device 800]

[0633] 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 the magnet generated from the magnetic coil built in the insertion portion 110H of the endoscope 100H via an antenna. As shown in FIG. 8, the observation device 800 is configured such that the insertion portion 110H enters the reception range of the observation device 800, and thus, the magnet generated from the entirety of the insertion portion 110H can be received. FIG. 73

[0634] ​The observation device 800 infers the shape (first inferred shape) SS1 of the insertion part 110H based on the received magnetic field. The observation device 800 generates a three-dimensional graphic image of the shape SS1 and displays it on the display device 900. Alternatively, the observation device 800 can also be a device for observing the shape SS1 of the endoscope 100H by other methods such as X-ray photography. The observation results of the observation device 800 are also acquired by the main controller 560.

[0635] The shapes of the insertion portion 110H and the external flexible portion 140 are used, for example, to improve the precision of bending operations. Typically, the ratio of the line tension Tin at the base of the flexible portion to the line tension Tout at the front end is expressed as Tout / Tin = exp(-μθ) using the sum of the bending angles θ (hereinafter referred to as the total bending angle) of the flexible portion path and the coefficient of friction μ between the line and the sheath. For example, the precision of bending operations can be achieved by correcting the traction tension and traction amount of the line using the relationship stated on the left.

[0636] Next, the method of using the electric endoscope system 1000H of this embodiment will be described. Specifically, a surgical procedure for observing and treating a lesion on the wall of the large intestine using the electric endoscope system 1000H will be described.

[0637] From now on, according to FIG. 74 The control flowchart of the main controller 560 of the control device 600 is explained below. When the control device 600 is started, the main controller 560 performs initialization and then begins control (step S800). Next, the main controller 560 (mainly the processor 561) executes step S810.

[0638] The surgeon S inserts the insertion part 110H of the endoscope 100H into the large intestine of the patient P through the anus. 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 and moves the insertion part 110H so that the front end 111 is close to the affected area. In addition, 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 300, bending the bending part 112 as needed.

[0639] In step S810, the main controller 560 obtains the shape SS1 of the insertion part 110H from the observation device 800. Next, the main controller 560 executes step S820.

[0640] In step S820, the main controller 560 obtains the position and attitude of the base end of the external flexible part 140 from the loading / unloading position and attitude sensor 1504. Then, the main controller 560 executes step S830.

[0641] In step S830, the main controller 560 acquires the position and posture of the vicinity of the distal end of the extracorporeal flexible section 140 from the endoscope position and posture sensor 732. Then, the main controller 560 proceeds to step S840.

[0642] In step S840, the main controller 560 estimates the shape of the extracorporeal flexible section 140 (second estimated shape) SS2 based on the position and posture acquired from the attachment / detachment position and posture sensor 1504 and the endoscope position and posture sensor 732. The main controller 560 estimates the position and posture of the other portions of the extracorporeal flexible section 140 from the position and posture of the proximal end portion of the extracorporeal flexible section 140 and the position and posture of the vicinity of the distal end of the extracorporeal flexible section 140, thereby estimating the shape of the extracorporeal flexible section 140 SS2. Then, the main controller 560 proceeds to step S850.

[0643] In step S850, the main controller 560 generates or updates the path of the bending wire 160 (estimated path) SR based on the estimated shape of the insertion section 110H (first estimated shape, insertion section shape information) SS1 and the shape of the extracorporeal flexible section 140 (second estimated shape, extracorporeal shape information) SS2.

[0644] The main controller 560 then proceeds to step S860. In step S860, the main controller 560 determines whether or not to end the control. In the case where the control is not ended, the main controller 560 again proceeds to step S810. In the case where the control is ended, the main controller 560 then proceeds to step S870 and ends the control.

[0645] The generated or updated estimated path SR of the bending wire 160 is acquired by the drive controller 260. The drive controller 260 calculates the transmission efficiency of the bending wire 160 based on the estimated path SR and the like, and calculates the actual pulling amount and feeding amount of the bending wire 160 when controlling the wire drive section 250 based on the operation input acquired from the operation device 300 to operate the bending section 112. As a result, the drive controller 260 can more accurately operate the bending section 112.

[0646] According to the electric endoscope system 1000H of the present embodiment, the observation or treatment using the endoscope 100H can be more efficiently performed. Since the endoscope 100H and the operation device 300 are separated, the surgeon S can independently operate them without affecting each other.

[0647] With the driving device 200 separated from the operation device 300, the path of the bending line 160 from the insertion portion 110H of the endoscope 100H to the driving device 200 is sometimes lengthened, but the driving controller 260 easily causes the bending portion 112 to bend accurately by calculating the transmission efficiency of the bending line 160 based on the estimated path SR and the like.

[0648] In the case where the extracorporeal flexible portion 140 is lengthened, it is difficult to generate the path estimation path SR of the bending line 160 only by observing the observation result of the observation device 800. The motor-driven endoscope system 1000H uses the shape SS2 of the extracorporeal flexible portion 140 estimated based on the position and posture acquired from the attachment / detachment position and posture sensor 1504 and the endoscope position and posture sensor 732 in addition to the shape SS1 of the insertion portion 110H observed by the observation device 800. As a result, the motor-driven endoscope system 1000H can generate a more accurate path estimation path SR.

[0649] The eighth embodiment of the present application has been described above with reference to the drawings, but the specific structure is not limited to this embodiment, and design changes and the like within the scope of the gist of the present application are also included. Furthermore, the structural elements shown in the above embodiments and modified examples can be appropriately combined.

[0650] (Modified example 8-1)

[0651] In the above embodiments, the endoscope support portion 730 supports the extracorporeal flexible portion 140 of the endoscope 100H. However, the mode of the endoscope support portion 730 is not limited to this. The endoscope support portion 730 can also support the intracorporeal flexible portion 119 of the endoscope 100H to detect the position and posture of the intracorporeal flexible portion 119. Furthermore, the endoscope support portion 730 can also support the connecting portion 120 of the endoscope 100H to detect the position and posture of the connecting portion 120.

[0652] (Modified example 8-2)

[0653] In the above-described embodiments, the main controller 560 estimates the shape SS2 of the extracorporeal flexible section 140 based on the position and posture acquired from the attachment / detachment position and posture sensor 1504 and the endoscope position and posture sensor 732. However, the method of estimating the shape of the extracorporeal flexible section 140 is not limited to this. The main controller 560 can estimate the shape SS2 of the extracorporeal flexible section 140 based on only the output of either of the attachment / detachment position and posture sensor 1504 and the endoscope position and posture sensor 732. Further, the main controller 560 can estimate the shape SS2 of the extracorporeal flexible section 140 taking into account the length of the extracorporeal flexible section 140 in addition to the position acquired from the attachment / detachment position and posture sensor 1504 and the endoscope position and posture sensor 732, whereby more accurate estimation can be performed. Further, the main controller 560 can estimate the shape SS2 of the extracorporeal flexible section 140 based on the total bending angle of the extracorporeal flexible section 140 and the roller rotation amount.

[0654] (Variation 8-3)

[0655] The main controller 560 can estimate the shape SS2 of the extracorporeal flexible section 140 from the image of the extracorporeal flexible section 140 acquired from the camera 570. If a marker is installed in advance at the tip end and the base end of the extracorporeal flexible section 140, the main controller 560 can estimate the shape SS2 of the extracorporeal flexible section 140 with higher accuracy.

[0656] (Ninth Embodiment)

[0657] Reference FIG. 75 An electric endoscope system 1000I of a ninth embodiment of the present application will be described. In the following description, the same reference numerals are annotated for structures common to those already described, and repeated description is omitted. FIG. 76 is a general view of the electric endoscope system 1000I of the present embodiment.

[0658] [Electric endoscope system 1000I]

[0659] As shown in ​ , the electric endoscope system 1000I is a medical system that performs observation and treatment of the inside of a patient P lying on his or her back on a surgical table T. The electric endoscope system 1000I is provided with an endoscope 100C, a drive device 200I, an operation 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.

[0660] [Drive device 200I]

[0661] ​ is a functional block diagram of the drive device 200I.

[0662] The driving device 200I is provided with the adapter 210C, the operation reception section 220, the air feeding and suction driving section 230, the wire driving section 250C, and the driving controller 260I.

[0663] The driving device 200I, like the driving device 200C of the third embodiment, is capable of independently driving a pair of bending wires that bend the bending portion 112 in the UD direction. Further, the electric endoscope system 1000I is capable of independently driving a pair of bending wires 160 that bend the bending portion 112 in the LR direction.

[0664] [Driving controller 260I]

[0665] The driving controller 260I controls the entire driving device 200I. The driving controller 260I differs from the driving controller 260C of the third embodiment in the control method of the wire driving section 250C. The driving controller 260I switches the driving mode of the wire driving section 250C based on the bending shape of the bending portion 112. The driving controller 260I is capable of switching the driving mode of the wire driving section 250C to either one of the first driving mode and the second driving mode.

[0666] [Restoring force F1 and friction force F2]

[0667] The restoring force F1, which is a force to return the bending portion 112 to a straight state, and the friction force F2, which is a force to maintain the shape against the restoring force F1, act in the bent bending portion 112.

[0668] ​ is a graph showing the restoring force F1 acting on the bent bending portion 112.

[0669] The restoring force F1 is the repulsive force F11 of the elastic member such as rubber forming the sheath 118, the contraction force F12, and the bending reaction force F13 of the built-in object 170.

[0670] ​ is a graph showing the friction force F2 acting on the bent bending portion 112.

[0671] The friction force F2 is the friction force F21 between the link 115 and the link 115, the friction force F22 between the bending wire 160 and the wire guide section (the upper wire guide section 115u, the lower wire guide section 115d, the left wire guide section 115l, and the right wire guide section 115r), and the like.

[0672] ​ is a graph showing the relationship between the bending angle θ of the bending portion 112 and the restoring force F1.

[0673] The bending angle θ is a bending angle of the bending portion 112 measured from a center axis O of the length direction A in the straight state of the bending portion 112. The greater the bending angle θ, the greater the restoring force Fl. On the other hand, the smaller the bending angle θ, the smaller the restoring force Fl. When the bending angle θ is smaller than a prescribed angle, the restoring force Fl is smaller than the friction force F2.

[0674] The bending shape of the bending portion 112 in which the restoring force Fl is greater than the friction force F2 (Fl > F2) is set to "first shape". The bending shape of the bending portion 112 in which the restoring force Fl is equal to or smaller than the friction force F2 (Fl ≦ F2) is set to "second shape".

[0675] [First driving mode]

[0676] The driving controller 260I switches the driving mode of the wire driving portion 250C to the first driving mode in a case where the bending portion 112 is bent in a manner that the bending angle θ is increased. Further, the driving controller 260I switches to the first driving mode in a case where the bending portion 112 is bent in a manner that the bending angle θ is decreased and when the bending shape of the bending portion 112 is the first shape. In the first driving mode, the driving controller 260I performs position control on the bending wire 160 on the inner diameter side in a pair of opposing bending wires 160 (opposing wires) that bend the bending portion 112 in the UD direction or the LR direction and performs tension control on the bending wire 160 on the outer diameter side.

[0677] The bending wire 160 on the inner diameter side in the opposing wires is a bending wire 160 that is located on the inner side when viewed from the center of curvature in the bent bending portion 112. The bending wire 160 on the outer diameter side in the opposing wires is a bending wire 160 that is located on the outer side when viewed from the center of curvature in the bent bending portion 112.

[0678] The position control is a control method that calculates the pulling amount or the feeding amount of the bending wire 160 based on a target position at which the bending portion 112 is moved by bending.

[0679] The tension control is a control method that calculates the pulling amount or the feeding amount of the bending wire 160 so that the tension of the bending wire 160 coincides with a control value.

[0680] In a case where the driving mode of the wire driving portion 250C is the first driving mode, the driving controller 260I performs position control on the bending wire 160 on the inner diameter side, whereby the bending angle θ is accurately controlled against the restoring force Fl. On the other hand, the driving controller 260I performs tension control on the bending wire 160 on the outer diameter side, whereby the tension of the bending wire 160 is maintained at the control value.

[0681] When the drive mode of the online drive unit 250C is the first drive mode, the drive controller 260I performs position control on the bending line 160 on the inner diameter side, thereby strongly resisting the external reaction force in the direction where the bending angle θ increases. Therefore, the drive controller 260I can easily cause the bending section 112 to bend significantly, even inside the narrow interior of the large intestine.

[0682] [Second Drive Mode]

[0683] When the bending portion 112 is bent by decreasing the bending angle θ and the bending shape of the bending portion 112 is the second shape, the drive controller 260I switches the drive mode of the line drive unit 250C to the second drive mode. In the second drive mode, the drive controller 260I performs tension control on the inner diameter side of the bending line 160 of the pair of opposing bending lines 160 (opposite lines) that bend the bending portion 112 in the UD direction or the LR direction, and performs position control on the outer diameter side of the bending line 160.

[0684] When the bending shape of the bending section 112 is the second shape, the drive controller 260I performs position control on the bending line 160 on the outer diameter side, thereby assisting the restoring force F1, which is smaller than the frictional force F2, to prevent a decrease in the bending control speed. On the other hand, the drive controller 260I performs tension control on the bending line 160 on the inner diameter side, thereby maintaining the tension of the bending line 160 at the control value.

[0685] When the bending shape of the bending section 112 changes from the first shape to the second shape, the driving mode of the line drive section 250C is switched from the first driving mode to the second driving mode. As a result, the drive controller 260I can prevent the decrease in the bending speed caused by the decrease in the restoring force F1, and can smoothly control the bending action.

[0686] Next, the method of using the electric endoscope system 1000I of this embodiment will be described. From now on, according to... ​ The control flow diagram of the drive controller 260I of the control device 600I shown will be explained. 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 curved line 160 so that the curved portion 112 is in a straight state, eliminating the slack of the curved line 160. Next, the drive controller 260I (mainly the processor) executes step S910.

[0687] 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, the tension of the bending wire 160, and the like. The drive controller 260I can also estimate the bending angle Θ by the observation device 800 shown in the 8th embodiment. Next, the drive controller 260I executes step S920.

[0688] In step S920, the drive controller 260I switches the drive mode of the wire drive section 250C to either one of the first drive mode and the second drive mode based on the bending angle Θ. Next, the drive controller 260I executes step S930.

[0689] In step S930, the drive controller 260I acquires the operation input from the operation device 300. The drive controller 260I executes step S940 when the operation input from the operation device 300 is acquired.

[0690] In step S940, the drive controller 260I controls the wire drive section 250C based on the drive mode to drive the bending wire 160 to bend the bending section 112.

[0691] The drive controller 260I then executes step S950. In step S950, the drive controller 260I determines whether or not to end the control. When the control is not ended, the drive controller 260I executes step S910 again. When the control is ended, the drive controller 260I then executes step S960 and ends the control.

[0692] Part of the control flowchart of the drive controller 260I described above can also be executed by the main controller 560.

[0693] According to the electrically powered endoscope system 1000I of the present embodiment, the observation or treatment using the endoscope 100C can be more effectively performed. Since the endoscope 100C is separated from the operation device 300, the surgeon S can independently operate them without affecting each other.

[0694] With the separation of the driving device 200I from the operation device 300, the path of the bending line 160 from the insertion portion 110 of the endoscope 100C to the driving device 200I is sometimes lengthened, but the driving controller 260I easily causes the bending portion 112 to accurately bend by performing position control on one of the opposing wires and tension control on the other.

[0695] The driving controller 260I can judge which of the restoring force Fl and the frictional force F2 is dominant in the shape control of the bending portion 112 according to the bending shape (bending angle θ) of the bending portion 112. The driving controller 260I switches the driving mode of the wire driving portion 250C based on the above judgment. Therefore, the driving controller 260I can smoothly control the bending action of the bending portion 112.

[0696] The ninth embodiment of the present application has been described above with reference to the drawings, but the specific structure is not limited to this embodiment, and design changes and the like within the scope of the gist of the present application are also included. Furthermore, the structural elements shown in the above embodiments and modified examples can be appropriately combined.

[0697] (Modified Example 9-1)

[0698] In the above embodiment, the shape of the bending portion 112 is distinguished into the "first shape" in which the restoring force Fl is larger than the frictional force F2 and the "second shape" in which the restoring force Fl is equal to or smaller than the frictional force F2, based on only the bending angle θ. However, the distinguishing method of the first shape and the second shape is not limited to this. The shape of the bending portion 112 can be distinguished based on the entire pulling state of the bending line 160 in addition to the bending angle θ. For example, in the case where the first bending portion 113 and the second bending portion 114 are bent in the same direction, the restoring force Fl with respect to the bending angle θ becomes larger than in the case where only one is bent. In this case, the driving controller 260I can also change the threshold value of the bending angle θ that becomes the criterion for judging the first shape and the second shape.

[0699] (Modified Example 9-2)

[0700] In the above-described embodiment, the shape of the bent portion 112 is discriminated as the "first shape" in which the restoring force Fl is larger than the friction force F2 and the "second shape" in which the restoring force Fl becomes equal to or smaller than the friction force F2, based on the bending angle θ alone. However, the discrimination method of the first shape and the second shape is not limited to this. The shape of the bent portion 112 can be discriminated in accordance with the tension of the opposing wire in addition to the bending angle θ. For example, when the tension of the inner diameter side bending wire 160 that performs position control in the first driving mode is lower than the control value of the outer diameter side bending wire 160, it can also be determined that the shape has changed to the second shape and changed to the second driving mode.

[0701] (Tenth Embodiment)

[0702] Reference Figures 77 to 80 An electric endoscope system 1000J of a tenth embodiment of the present application will be described. In the following description, the same reference numerals are annotated for structures common to those already described, and repeated description is omitted. Figure 77 is a general view of the electric endoscope system 1000J of the present embodiment.

[0703] [Electric Endoscope System 1000J]

[0704] As shown in Figure 77 , the electric endoscope system 1000J is a medical system that performs observation and treatment of the inside of a patient P who is lying on his or her side on an operating table T. The electric endoscope system 1000J is provided with an endoscope 100, a driving device 200, an operation device 300J, a treatment instrument 400, an image control device 500, and a display device 900.

[0705] [Operation Device 300J]

[0706] Figure 78 is a perspective view of the operation device 300J.

[0707] The operation device 300J is a device that inputs an operation for driving the endoscope 100. The input operation is transmitted to the driving device 200 via an operation cable 301. The operation device 300J can also communicate with the driving device 200 by wireless communication without wired communication. The operation device 300J has an input unit different from the operation device 300 of the first embodiment.

[0708] The operation device 300J is provided with an operation portion main body 310J and a touch panel 380. The operation device 300J is not provided with the first angle knob 320, the second angle knob 330, the switching switch 340, the air feeding button 350, the suction button 351, and various buttons 352. In addition, a second forceps opening fixing instrument 360 is mounted on the operation device 300J shown in Figure 77 ​

[0709] The operation unit main body 310J is formed in a substantially cylindrical shape that the surgeon S can hold with the left hand L. As shown in Figure 77 the back surface 311 along which the palm of the left hand L of the surgeon S can be formed on the operation unit main body 310J. The operation unit main body 310J has a touch panel support portion 314 extending from a front surface 312 on the side opposite to the back surface 311. The operation cable 301 is connected to the end portion in the longitudinal direction of the operation unit main body 310J.

[0710] In the following description, the direction in which the touch panel support portion 314 extends with respect to the operation unit main body 310J is defined as the "front-rear direction", and the direction in which the touch panel support portion 314 is provided with respect to the operation unit main body 310J is defined as the "front direction FR". The opposite direction thereof is defined as the "rear direction RR". Further, the longitudinal direction of the operation unit main body 310J is defined as the "up-down direction", and the direction in which the operation cable 301 is attached with respect 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 direction toward the right direction RH when facing the rear direction RR is defined as the "right direction RH". The opposite direction thereof is defined as the "left direction LH". The direction toward the right direction RH or the left direction LH is defined as the "left-right direction".

[0711] In the present embodiment, the direction in which the touch panel support portion 314 extends with respect to the operation unit main body 310J (the front-rear direction) is a direction substantially perpendicular to the back surface 311 of the operation unit main body 310J.

[0712] The touch panel support portion 314 supports the touch panel 380. When viewed from the front direction FR toward the rear direction RR, the touch panel support portion 314 is provided on the left direction LH of the front surface 312 of the operation unit main body 310J.

[0713] The touch panel 380 is provided on the side of the left direction LH of the touch panel support portion 314. The touch panel 380 faces the left direction LH. The touch panel 380 is provided at a position that is easily operated by the thumb of the left hand L of the surgeon S who holds the operation unit main body 310J.

[0714] The touch panel 380 has divided operation regions. The division of the operation regions in the touch panel 380 can be changed by mode setting. In the present embodiment, the touch panel 380 can be set to either one of a first mode and a second mode.

[0715] Figure 79 is a side view of the operation device 300J in which the touch panel 380 is set to the first mode. In the first mode, the touch panel 380 is divided into a first angle operation region R11, a second angle operation region R12, a switching operation region R13, a gas supply operation region R14, a suction operation region R15, and various operation regions R16.

[0716] The first angle operation area R11 and the second angle operation area R12 are rectangular areas extending in the vertical direction. The first angle operation area R11 and the second angle operation area R12 are arranged in the front-back direction. The first angle operation area R11 is located at the rear (RR), and the second angle operation area R12 is located at the front (FR).

[0717] The first angle operation area R11 is the area for inputting operations equivalent to those performed on the first angle knob 320 in the first embodiment. By moving the thumb, which is in contact with the first angle operation area R11, upward (UPR), an operation equivalent to rotating the first angle knob 320 clockwise when viewing from the front (FR) to the rear (RR) is input. By moving the thumb, which is in contact with the first angle operation area R11, downward (LWR), an operation equivalent to rotating the first angle knob 320 counterclockwise when viewing from the front (FR) to the rear (RR) is input. Operations input to the first angle operation area R11 are sent to the drive device 200.

[0718] The second angle operation area R12 is the area for inputting operations equivalent to those performed on the second angle knob 330 in the first embodiment. By moving the thumb, which is in contact with the second angle operation area R12, upward (UPR), an operation equivalent to rotating the second angle knob 330 clockwise when viewing from the front (FR) to the rear (RR) is input. By moving the thumb, which is in contact with the second angle operation area R12, downward (LWR), an operation equivalent to rotating the second angle knob 330 counterclockwise when viewing from the front (FR) to the rear (RR) is input. The operations input to the second angle operation area R12 are sent to the drive device 200.

[0719] like Figure 19 and Figure 79 As shown, when viewed from left (LH) towards right (RH), the first angle operation area R11 is positioned equivalent to the position of the first angle knob 320 of the operating device 300 in the first embodiment. Furthermore, when viewed from left (LH) towards right (RH), the second angle operation area R12 is positioned equivalent to the position of the second angle knob 330 of the operating device 300 in the first embodiment. Therefore, the surgeon S can operate the first angle operation area R11 and the second angle operation area R12 in the same way as operating the first angle knob 320 and the second angle knob 330.

[0720] The switch operation region R13, the air supply operation region R14, the suction operation region R15, and the various operation regions R16 are arranged at positions further forward FR than the second angle operation region R12. The switch operation region R13, the air supply operation region R14, the suction operation region R15, and the various operation regions R16 are arranged in order from the upper side UPR toward the lower side LWR.

[0721] The switch operation region R13 is a region in which an operation equivalent to the operation of the switch knob 340 of the first embodiment is input. The operation input to the switch operation region R13 is transmitted to the drive device 200.

[0722] The air supply operation region R14 is a region in which an operation equivalent to the operation of the air supply button 350 of the first embodiment is input. The operation input to the air supply operation region R14 is transmitted to the drive device 200.

[0723] The suction operation region R15 is a region in which an operation equivalent to the operation of the suction button 351 of the first embodiment is input. The operation input to the suction operation region R15 is transmitted to the drive device 200.

[0724] The various operation regions R16 are regions in which operations equivalent to the operations of the various buttons 352 of the first embodiment are input. The operation input to the various operation regions R16 is transmitted to the drive device 200.

[0725] Figure 80 is a side view of the operation device 300J in which the touch panel 380 is set to the second mode. In the second mode, the touch panel 380 is divided into the angle operation region R10, the switch operation region R13, the air supply operation region R14, the suction operation region R15, and the various operation regions R16.

[0726] The angle operation region R10 is a rectangular region. The angle operation region R10 is a region in which an operation equivalent to the operations of the first angle knob 320 and the second angle knob 330 of the first embodiment is input. The operation input to the angle operation region R10 is transmitted to the drive device 200.

[0727] The operation equivalent to the operation of the first angle knob 320 of the first embodiment is input by moving the thumb in contact with the angle operation region R10 in a direction (first direction) D1 along the up-down direction. The touch panel 380 corresponds the input in the direction (first direction) D1 in the angle operation region R10 to the operation of bending the first bent portion 113 or the second bent portion 114 in the UD direction. The operation of bending the first bent portion 113 or the second bent portion 114 upward in the UD direction is input by moving the thumb in contact with the angle operation region R10 upward UPR along the direction D1. The operation of bending the first bent portion 113 or the second bent portion 114 downward in the UD direction is input by moving the thumb in contact with the angle operation region R10 downward LWR along the direction D1.

[0728] The operation equivalent to the operation of the second angle knob 330 of the first embodiment is input by moving the thumb in contact with the angle operation region R10 in a direction (second direction) D2 along the front-rear direction. The touch panel 380 corresponds the input in the direction (second direction) D2 in the angle operation region R10 to the operation of bending the first bent portion 113 or the second bent portion 114 in the LR direction. The operation of bending the first bent portion 113 or the second bent portion 114 rightward in the LR direction is input by moving the thumb in contact with the angle operation region R10 forward FR (right side of the touch panel 380) along the direction D2. The operation of bending the first bent portion 113 or the second bent portion 114 leftward in the LR direction is input by moving the thumb in contact with the angle operation region R10 rearward RR (left side of the touch panel 380) along the direction D2.

[0729] The surgeon S can intuitively bend the first bent portion 113 or the second bent portion 114 by moving the thumb in contact with the angle operation region R10 in the direction D1 and the direction D2. In addition, the direction D1 is not limited to the up-down direction and the horizontal direction, and can include a direction inclined from the up-down direction. Furthermore, the direction D2 is not limited to the front-rear direction and the horizontal direction, and can include a direction inclined from the front-rear direction.

[0730] The switching operation region R13, the air supply operation region R14, the suction operation region R15, and the various operation regions R16 are arranged at a position lower than the angle operation region R10. The switching operation region R13, the air supply operation region R14, the suction operation region R15, and the various operation regions R16 are arranged in this order from the rearward RR toward the forward FR.

[0731] According to the electric endoscope system 1000J of this embodiment, observation or treatment using the endoscope 100 can be performed more efficiently. Since the endoscope 100 is separated from the operation device 300J, the surgeon S can operate the endoscope 100 and the operation device 300J independently without affecting each other.

[0732] An operation region that switches the mode setting to either one of the first mode and the second mode can also be provided on the touch panel 380. The surgeon S can switch the mode setting of the touch panel 380 by operating the touch panel 380.

[0733] According to the electric endoscope system 1000J of this embodiment, the operation device 300J does not have movable components such as buttons and switches, and is easy to clean. In addition, the operation device 300J is small and light because of the small number of components. Therefore, the surgeon S can easily operate the operation device 300J with only the left hand L.

[0734] The tenth embodiment of the present application has been described above with reference to the drawings, but the specific structure is not limited to this embodiment, and design changes and the like within the scope of the gist of the present application are also included. In addition, the structural elements shown in the above-described embodiments and modified examples can be appropriately combined.

[0735] (Modified example 10-1)

[0736] In the above-described embodiments, the operation device 300J has the touch panel 380 that inputs an operation. However, the manner of the operation device 300J is not limited to this. The touch panel 380 of the operation device 300J can also be a touch panel that has a display such as a liquid crystal panel. By displaying the operation regions (R11 to R16) of the touch panel 380 on the display, the surgeon S can easily grasp the positions of the operation regions (R11 to R16).

[0737] (Eleventh embodiment)

[0738] Reference Figures 81 to 82 An electric endoscope system 1000K of the eleventh embodiment of the present application will be described. In the following description, the same reference numerals are assigned to structures common to those already described, and repeated description is omitted. Figure 81 is a whole view of the electric endoscope system 1000K of this embodiment.

[0739] [Electric endoscope system 1000K]

[0740] As Figure 81As shown, the motor-driven endoscope system 1000K is a medical system that observes and treats the inside of a patient P who is lying on his or her back on an operating table T. The motor-driven endoscope system 1000K is provided with an endoscope 100, a driving 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 a forceps opening 126 of a joint portion 120 to a channel tube 171 of the endoscope 100 without passing through an extension channel tube 130.

[0741] [Operating device 300K]

[0742] Figure 82 is a perspective view of the operating device 300K.

[0743] The operating device 300K is a device that inputs operations for driving the endoscope 100. The input operations are transmitted to the driving device 200 via an operating cable 301. The operating device 300K can also communicate with the driving device 200 by wireless communication instead of wired communication. The operating device 300K has an input unit different from that of the operating device 300 of the first embodiment.

[0744] The operating device 300K is provided with an operating portion main 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.

[0745] The operating portion main body 310K is formed in a shape similar to a game controller. The operating portion main body 310K has a main body portion 315, a right handle 316, and a left handle 317. The main body portion 315 is disposed between the right handle 316 and the left handle 317. The surgeon S supports the operating device 300K by holding the right handle 316 with the right hand R and holding the left handle 317 with the left hand L.

[0746] 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 holds the left handle 317 with the left hand L is defined as a front direction FR. The opposite direction thereof is defined as a rear direction RR. The direction toward the front direction FR or the rear direction RR is defined as a front-rear direction. The direction in which the right handle 316 is attached to the operating portion main body 310K is defined as a right direction RH. The direction in which the left handle 317 is attached to the operating portion main body 310K is defined as a left direction LH. The direction toward the right direction RH or the left direction LH is defined as a right-left direction. The upward direction when facing the rear direction RR is defined as an upward direction UPR. The opposite direction thereof is defined as a downward direction LWR. The direction toward the upward direction UPR or the downward direction LWR is defined as an upward-downward direction.

[0747] The first lever 321, the second lever 322, the third lever 323, the switching switch 340K, the first button 350K, the second button 351K, and the third button 352K are arranged on the front surface 312 of the main body 315. The surgeon S mainly operates the first lever 321, the first button 350K, and the like by the thumb.

[0748] The first lever 321 is a lever that inputs an operation of bending the first bending portion 113 in the UD direction and the LD direction, similarly to the operation input in the first bending portion control mode Ml of the second embodiment. The operation of bending the first bending portion 113 in the UD direction is input by the surgeon S moving the first lever 321 in the up-down direction. When the surgeon S moves the first lever 321 in the left-right direction, the operation of bending the first bending portion in the LR direction is input. The operation input to the first lever 321 is transmitted to the drive device 200.

[0749] The second lever 322 is a lever that inputs an operation of bending the second bending portion 114 in the UD direction and the LD direction, similarly to the operation input in the second bending portion control mode M2 of the second embodiment. The operation of bending the second bending portion 114 in the UD direction is input by the surgeon S moving the second lever 322 in the up-down direction. When the surgeon S moves the second lever 322 in the left-right direction, the operation of bending the second bending portion 114 in the LR direction is input. The operation input to the second lever 322 is transmitted to the drive device 200.

[0750] The third lever 323 is a lever that inputs an operation of bending the first bending portion 113 and the second bending portion 114 in the UD direction and the LD direction in coordination, similarly to the operation input in the coordinated control mode M3 of the second embodiment. The operation of bending the first bending portion 113 and the second bending portion 114 in the UD direction in coordination is input by the surgeon S moving the third lever 323 in the up-down direction. When the surgeon S moves the third lever 323 in the left-right direction, the operation of bending the first bending portion 113 and the second bending portion 114 in the LR direction in coordination is input. The operation input to the third lever 323 is transmitted to the drive device 200.

[0751] The first button 350K is a button that inputs an operation equivalent to the operation of the gas feeding button 350 for the first embodiment. The operation input to the first button 350K is transmitted to the drive device 200.

[0752] The second button 351K is a button that inputs an operation equivalent to the operation of the suction button 351 for the first embodiment. The operation input to the second button 351K is transmitted to the drive device 200.

[0753] The third button 352K is a button that inputs an operation equivalent to the operation of the various buttons 352 for the first embodiment. The operation input to the third button 352K is transmitted to the driving device 200.

[0754] The first lever 321 and the second lever 322 are disposed at positions operable with the thumb of the left hand L when the surgeon S holds the left handle 317 with the left hand L. Therefore, the surgeon S can input an operation to bend the first bending portion 113 and the second bending portion 114 even in a case where the right hand R is removed from the operation device 300K in order to operate the insertion portion 110 of the endoscope 100.

[0755] The first lever 321 that operates the first bending portion 113 is disposed at a position higher UPR than the second lever 322 that operates the second bending portion 114 and is disposed on the distal side for the surgeon S. Therefore, the surgeon S can intuitively distinguish between the first lever 321 and the second lever 322.

[0756] According to the electric endoscope system 1000K of the present embodiment, an operation input corresponding to each bending mode can be input to the operation device 300K without switching the bending mode. The surgeon S can rapidly input a complicated operation input without switching the bending mode by becoming familiar with the operation input for the first lever 321 and the like.

[0757] The eleventh embodiment of the present application has been described above with reference to the drawings, but the specific structure is not limited to this embodiment and includes design changes and the like within a range not departing from the gist of the present application. Furthermore, the structural elements shown in the above-described embodiments and modified examples can be appropriately combined to constitute.

[0758] (Modified example 11-1)

[0759] In the above-described embodiment, the operation input assigned to the first joystick 321 or the first button 350K and the like is fixed. However, the manner of assigning the operation input to the first joystick 321 or the first button 350K and the like is not limited to this. The manner of assigning the operation input to the first joystick 321 or the first button 350K and the like can also be changed. For example, the assignment of the operation input can also be changed by a switch 340K or the like according to the preference of the surgeon S so that the operation of bending the second bending portion 114 is input to the first joystick 321 and the operation of bending the first bending portion 113 is input to the second joystick 322. Further, the assignment of the operation input can also be changed by a switch 340K or the like according to the preference of the surgeon S so that the operation equivalent to the operation of the suction button 351 of the first embodiment is input to the first button 350K and the operation equivalent to the operation of the air feeding button 350 of the first embodiment is input to the second button 351K.

[0760] (Modified example 11-2)

[0761] In the above-described embodiment, the operation device 300K is provided with a joystick and a button. However, the operation input portion provided by the operation device 300K is not limited to this. The operation device 300K can also be provided with a sensor such as a gyro sensor or an acceleration sensor as the operation input portion.

[0762] (Modified example 11-3)

[0763] The shape of the operation device 300K and the configuration of the operation input portion (joystick, button) provided by the operation device 300K are not limited to the above-described embodiment. The operation device 300K can have a plurality of modifications different in shape and configuration of the operation input portion. The surgeon S can select and use the operation device 300K easy to use from among the plurality of modifications.

[0764] In the case where a plurality of modified examples of the operation device 300K are connected to the drive device 200, the operation device 300K desirably has a safety mechanism indicating that it is an operation device 300K whose suitability and safety to the drive device 200 are certified. The safety mechanism is a mechanism appropriately selected from known safety mechanisms such as a security chip. The drive device 200 can determine whether or not the operation device 300K connected to the drive device 200 has been certified based on the presence or absence of the safety mechanism. If the operation device 300K has the safety mechanism, it is possible to prevent the operation device 300K whose suitability and safety to the drive device 200 are not certified from being connected to and used with the drive device 200.

[0765] (Twelfth embodiment)

[0766] Reference Signs Figures 83 to 87An electric endoscope system 1000L of a twelfth embodiment of the present application will be described. In the following description, the same reference numerals are annotated for structures common to those already described, and repeated description is omitted. Figure 83 is a whole view of the electric endoscope system 1000L of the present embodiment.

[0767] [Electric endoscope system 1000L]

[0768] As shown in Figure 83 , the electric endoscope system 1000L is a medical system that performs observation and treatment of a patient P lying on his or her back on an operating table T. The electric endoscope system 1000L is provided with an endoscope 100, a driving 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 a forceps opening 126 of a joint portion 120 to a channel tube 171 of the endoscope 100 without passing through an extension channel tube 130.

[0769] [Operating device 300L]

[0770] The operating device 300L is a device that inputs an operation for driving the endoscope 100. The input operation is transmitted to the driving device 200 through wireless communication. The operating device 300L is not connected to the driving device 200 through an operating cable 301.

[0771] Figure 84 is a perspective view of the operating device 300L viewed from the back surface 311.

[0772] The operating device 300L is provided with an operating portion main body 310, a first angle knob 320, a second angle knob 330, a switching switch 340, an air feeding button 350, a suction button 351, various buttons 352, and a mounting adapter 390.

[0773] The mounting adapter 390 is an adapter that mounts the operating portion main body 310 to the extracorporeal flexible portion 140 in a detachable manner. In a case where the operating device 300L is not mounted to the extracorporeal flexible portion 140 and held by the operating surgeon S, the mounting adapter 390 is detached from the operating portion main body 310. The mounting adapter 390 has a first mounting portion 391 and a second mounting portion 392.

[0774] The first mounting portion 391 mounts the mounting adapter 390 to the back surface 311 of the operating portion main body 310, for example, by a screw 391a. The first mounting portion 391 can also mount the mounting adapter 390 to the back surface 311 of the operating portion main body 310 by an adhesive tape or the like.

[0775] Figure 85 is a perspective view of the operating device 300L mounted to the extracorporeal flexible portion 140.

[0776] The second mounting portion 392 mounts the mounting adapter 390 to the extracorporeal flexible portion 140 in a detachable manner. The second mounting portion 392 is formed in a substantially cylindrical shape capable of holding the extracorporeal flexible portion 140 to an inner peripheral surface, and is formed with a slit 392b extending along a lengthwise direction. The surgeon S elastically deforms the second mounting portion 392 to widen a gap of the slit 392b, and passes the extracorporeal flexible portion 140 therethrough, whereby the second mounting portion 392 can be detached with respect to the extracorporeal flexible portion 140.

[0777] Figure 86 is a view illustrating a method of using the power-driven endoscope system 1000L.

[0778] Next, a method of using the power-driven endoscope system 1000L of the present embodiment will be described. The surgeon S mounts the operating device 300L to the extracorporeal flexible portion 140. The surgeon S can hold the operating device 300L with the left hand L and also hold the extracorporeal flexible portion 140 at the same time.

[0779] The surgeon S observes the captured image displayed on the display device 900, and operates the intracorporeal flexible portion 119 with the right hand R while moving the insertion portion 110. Further, the surgeon S operates the first angle knob 320 and the second angle knob 330 of the operating device 300L with the left hand L, and bends the bending portion 112 as necessary.

[0780] As shown in Figure 86 , the surgeon S holds the extracorporeal flexible portion 140 with the left hand L while moving the insertion portion 110 while operating the intracorporeal flexible portion 119 with the right hand R. Therefore, the surgeon S can advance and retract the extracorporeal flexible portion 140 with the left hand L to assist the operation of the intracorporeal flexible portion 119 with the right hand R. As a result, the surgeon S can appropriately operate the intracorporeal flexible portion 119 compared to the case where the intracorporeal flexible portion 119 is operated with only the right hand R.

[0781] According to the power-driven endoscope system 1000L of the present embodiment, the observation or treatment using the endoscope 100 can be more effectively performed. Although the endoscope 100 is separated from the operating device 300L, the operating device 300L is mounted to the endoscope 100 by the mounting adapter 390. The surgeon S can hold the operating device 300L and the extracorporeal flexible portion 140 at the same time with the left hand L. Further, the surgeon S can advance and retract the extracorporeal flexible portion 140 with the left hand L to assist the operation of the intracorporeal flexible portion 119 with the right hand R. Further, since the operating device 300L is attached to the extracorporeal flexible portion 140, the surgeon S can leave the left hand L from the operating device 300L and perform other work with the left hand L.

[0782] The above describes the twelfth embodiment of the present application with reference to the drawings, but the specific structure is not limited to this embodiment, and design modifications and the like within a range not departing from the gist of the present application are also included. Furthermore, the structural elements shown in the above embodiments and modified examples can be appropriately combined to constitute.

[0783] (Modified Example 12-1)

[0784] In the above embodiment, the mounting adapter 390 is attached to the extracorporeal flexible section 140 in a detachable manner. However, the mounting method of the mounting adapter 390 is not limited to this. For example, the mounting adapter 390 can also be attached to the intracorporeal flexible section 119 in a detachable manner.

[0785] (Modified Example 12-2)

[0786] In the above embodiment, the operation section main body 310 is formed separately from the mounting adapter 390. However, the operation section main body 310 and the mounting adapter 390 can also be formed integrally.

[0787] (Modified Example 12-3)

[0788] In the above embodiment, the operation device 300L is obtained by attaching the mounting adapter 390 to the operation device 300 of the first embodiment. However, the operation device 300L is not limited to this. Figure 87 FIG. 12 is a view showing an operation device 300LA as a modified example of the operation device 300L. The operation device 300LA includes an operation section main body 310LA, a joystick 320LA, and a mounting adapter 390. The operation section main body 310LA is formed to be small, and is easily held by only the left hand L. The joystick 320LA is provided to the operation section main body 310LA, and inputs an operation identical to the operation to the first joystick 321 or the second joystick 322. The mounting adapter 390 mounts the operation section main body 310LA to the extracorporeal flexible section 140 in a detachable manner. Since the operation device 300LA is formed to be small, the surgeon S easily operates the joystick 320LA even in a state where the operation device 300LA and the extracorporeal flexible section 140 are held by the left hand L at the same time.

[0789] The program in each embodiment can also be recorded on a computer-readable recording medium, and realized by causing a computer system to read in and execute the program recorded on the recording medium. In addition, the "computer system" includes an OS, peripheral devices, and the like hardware. Furthermore, the "computer-readable recording medium" refers to a removable medium such as a flexible disk, a magneto-optical disk, a ROM, a CD-ROM, and the like, a storage device such as a hard disk built into a computer system, and the like storage device. Furthermore, the "computer-readable recording medium" can also include a recording medium that dynamically stores a program for a short time, such as a communication line when the program is transmitted via a network such as the Internet or a communication line such as a telephone line, and a recording medium that stores a program for a certain period of time, such as a volatile memory inside a computer system that is a server or a client in this case. In addition, the above program can be used to realize a part of the above functions, or can realize the above functions by being combined with a program already recorded in a computer system.

[0790] Industrial applicability

[0791] The present application can be applied to a medical system that observes and treats a lumen organ or the like.

[0792] Explanation of reference numerals

[0793] 2000 billing system

[0794] 2100 electric endoscope group

[0795] SV1 billing server

[0796] SV2 hospital server

[0797] 1000, 1000B electric endoscope system

[0798] 100 endoscope

[0799] 200 drive device

[0800] 300 operation device

[0801] 400 treatment instrument

[0802] 500 image control device

[0803] 600, 600B control device

[0804] 900 display device

Claims

1. An endoscope system that outputs user feedback on endoscope usage, the endoscope system comprising the endoscope and a processor. The endoscope has an operating section that switches between two bending modes for the endoscope's curved section: one corresponding to basic functions and the other to additional functions that are billed. The processor performs the following processing: Obtain a case identifier corresponding to the case using the endoscope. The case identifier is generated based on a combination of patient ID, date ID or examination form ID provided by the hospital, and endoscope ID. Each case corresponds one-to-one with the case identifier. Billing information related to the use of the additional function is generated according to the case identifier, so that even if the additional function is used more than twice for the observation or treatment of a case, the billing amount in the billing information is the same as the billing amount for using the additional function once for the case.

2. The endoscope system according to claim 1, wherein, The processor performs the following processing: Determine whether the surgical observation or treatment of the case has ended; During the period of surgical observation or treatment of the case corresponding to the case identifier, the billing information is not sent to an external server. as well as At the point when the surgical observation or treatment of the case corresponding to the case identifier ends, the billing information is output to the external server.

3. The endoscope system according to claim 1, wherein, The processor performs the following processing: Detect the status of the additional function being used; If billing information already associated with the case identifier is generated, no new billing information associated with the case identifier will be generated. as well as If the state of the additional function being used is detected and no billing information associated with the case identifier is generated, new billing information associated with the case identifier is generated and output.

4. The endoscope system according to claim 3, wherein, The processor does not output the billing information to the external server during the period of observation or treatment of the case corresponding to the case identifier, and outputs the billing information to the external server at the time when the observation or treatment of the case ends.

5. The endoscope system according to claim 3, wherein, The processor calculates the cumulative time the additional function was used during the observation or treatment of the case corresponding to the case identifier. The processor outputs information related to the accumulated time along with the billing information.

6. The endoscope system according to claim 3, wherein, The processor can be communicatively connected to the hospital's internal systems. The processor obtains the case identifier by calculating a hash value corresponding to the ID output from the hospital's internal system.

7. The endoscope system according to claim 3, wherein, The processor performs the following processing: When the billing information associated with the case identifier is generated, the generated billing information is recorded in the memory; If the billing information associated with the case identifier is recorded in the memory, no new billing information associated with the case identifier is generated. as well as If the state in which the additional function is used is detected and the billing information associated with the case identifier is not recorded in the memory, new billing information associated with the case identifier is generated and output.

8. A control device for an endoscope system that outputs user feedback on the use of an endoscope, the control device comprising the endoscope and a processor. The control device switches the bending mode of the endoscope to correspond to the basic functions and the additional functions that are billed. The control device performs the following processing: Obtain a case identifier corresponding to the case using the endoscope, the case identifier being generated based on a combination of patient ID, date ID or examination form ID provided by the hospital, and endoscope ID, with each case corresponding to the case identifier; Billing information related to the use of the additional function is generated according to the case identifier, so that even if the additional function is used more than twice for the observation or treatment of a case, the billing amount in the billing information is the same as the billing amount for using the additional function once for the case.

9. The control device according to claim 8, wherein, The control device performs the following processing: Determine whether the surgical observation or treatment of the case has ended; During the period of surgical observation or treatment of the case corresponding to the case identifier, the billing information is not sent to an external server. as well as At the point when the surgical observation or treatment of the case corresponding to the case identifier ends, the billing information is output to the external server.

10. The control device according to claim 9, wherein, The control device performs the following processing: Detect the status of the additional function being used; If billing information already associated with the case identifier is generated, no new billing information associated with the case identifier will be generated. as well as If the state of the additional function being used is detected and no billing information associated with the case identifier is generated, new billing information associated with the case identifier is generated and output.

11. The control device according to claim 10, wherein, The control device does not output the billing information to the external server during the observation or treatment of the case corresponding to the case identifier, and outputs the billing information to the external server at the end of the observation or treatment of the case.

12. The control device according to claim 11, wherein, The control device calculates the cumulative time the additional function is used during the observation or treatment of the case corresponding to the case identifier. The control device outputs information related to the accumulated time along with the billing information.

13. The control device according to claim 12, wherein, The control device can be communicatively connected to the hospital's internal systems. The control device obtains the case identifier by calculating a hash value corresponding to the ID output from the hospital's internal system.

14. The control device according to claim 13, wherein, The control device performs the following processing: When the billing information associated with the case identifier is generated, the generated billing information is recorded in the memory; If the billing information associated with the case identifier is recorded in the memory, no new billing information associated with the case identifier is generated. as well as If the state in which the additional function is used is detected and the billing information associated with the case identifier is not recorded in the memory, new billing information associated with the case identifier is generated and output.

15. An information processing method for an endoscope system, the endoscope system comprising an endoscope and a control device having a processor, wherein, In the information processing method, The bending mode of the endoscope is switched to correspond to the basic function and the bending mode is switched to correspond to the additional function that is subject to billing. A case identifier is obtained corresponding to the case using the endoscope. This case identifier is generated based on a combination of a patient ID, date ID or examination report ID provided by the hospital, and an endoscope ID. Each case corresponds one-to-one with the case identifier. Billing information related to the use of the additional function is generated according to the case identifier, so that even if the additional function is used more than twice for the observation or treatment of a case, the billing amount in the billing information is the same as the billing amount for using the additional function once for the case.

16. The information processing method according to claim 15, wherein, Detect the status of the additional function being used. If billing information already associated with the case identifier is generated, no new billing information associated with the case identifier will be generated. If the state of the additional function being used is detected and no billing information associated with the case identifier is generated, new billing information associated with the case identifier is generated and output.

17. The information processing method according to claim 16, wherein, The billing information is not output to the external server during the period of observation or treatment of the case corresponding to the case identifier, and is output to the external server at the time when the observation or treatment of the case ends.

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