Endoscope and endoscope system

Abstract

An endoscope and an endoscope system are provided. The endoscope includes an insertion section provided with an imaging unit at a distal end section and inserted into an organ of a subject, an operation section provided at a proximal end of the insertion section, and a sensor provided to the operation section and detecting a pressure of a fluid in a flow path that penetrates from the operation section to a first opening of the distal end section and through which the fluid flowing into the operation section flows out.

Description

Technical Field

[0001] This invention relates to an endoscope for estimating intra-organ pressure and an endoscopic system for estimating intra-organ pressure. Background Technology

[0002] Endoscopes are widely used in both medical and industrial fields. In the medical field, endoscopes are used to visualize organs by inserting the endpiece into the body of the patient, or to manipulate organs using instruments inserted into the forceps channel and protruding from the front end of the endpiece.

[0003] For example, in the treatment of kidney stones, the insertion part of a renal pelvis endoscope (renal pelvis ureteroscope) is inserted into the renal pelvis through the ureter. Then, a laser probe, which serves as a treatment instrument, is inserted through the forceps channel inserted into the insertion part, and the stone is destroyed by laser irradiation.

[0004] Due to stone fragments and bleeding, the visual clarity of the endoscope is sometimes reduced. Therefore, perfusion fluid is injected into the renal pelvis through the forceps channel. The perfusion fluid injected into the renal pelvis flows out of the body through the access sheath with the insertion portion.

[0005] Japanese Patent Application Publication No. 2021-58422 discloses a system for managing the balance between the supply and outflow of perfusion fluid in order to properly maintain intrarenal pelvic pressure.

[0006] U.S. Patent Application Publication No. 2020 / 0196839 discloses an endoscope that detects the internal pressure of an organ by placing a pressure sensor at the front end of the insertion portion. Summary of the Invention

[0007] The problem that the invention aims to solve

[0008] If the infused volume of perfusion fluid exceeds the outflow volume, the intrarenal pelvic pressure will increase. Therefore, endoscopes and endoscopic systems require high-precision estimation of intrarenal pelvic pressure and appropriate management of the infused volume of perfusion fluid.

[0009] Methods for solving problems

[0010] The endoscope of the embodiment includes: an insertion part having an imaging unit disposed at its front end and inserted into an organ of the subject; an operating part disposed at the base end of the insertion part; and a sensor disposed in the operating part to detect the pressure of fluid in a flow path extending from the operating part to a first opening at the front end, and allowing the fluid flowing into the operating part to flow out from the first opening.

[0011] The endoscopic system of this embodiment includes: an endoscope comprising: an insertion portion having an imaging unit disposed at its front end and inserted into an organ of a subject; an operating portion disposed at the base end of the insertion portion; a sensor disposed on the operating portion for detecting the pressure of a gas in a flow path extending from the operating portion to a first opening at the front end, and for supplying the gas flowing into the operating portion to flow out into the organ through the first opening; a forceps channel disposed on the flow path; a gas supply unit for supplying gas to the flow path; a fluid supply unit for supplying perfusion fluid to the forceps channel; and an access sheath through which the insertion portion is inserted, and for the perfusion fluid injected into the organ from the first opening to be released externally through a gap between the access sheath and the insertion portion.

[0012] Invention Effects

[0013] The endoscope and endoscope system according to the embodiments can accurately estimate the intrarenal pelvis pressure and appropriately manage the injection volume of perfusion fluid. Attached Figure Description

[0014] Figure 1 This is a perspective view of an endoscope system including the endoscope of the first embodiment.

[0015] Figure 2 This is a cross-sectional view of the main parts of an endoscope system including the endoscope of the first embodiment.

[0016] Figure 3 It is along Figure 2 A cross-sectional view along line III-III.

[0017] Figure 4 This is a graph showing the pressure changes detected by the pressure sensor in the endoscope system of the first embodiment.

[0018] Figure 5 This is a cross-sectional view of the main part of an endoscope system including a modified example of the first embodiment of the endoscope.

[0019] Figure 6 This is a cross-sectional view of the main part of an endoscope system including the endoscope of the second embodiment. Detailed Implementation

[0020] Embodiments of the present invention will be described with reference to the accompanying drawings. The drawings, based on the embodiments, are schematic diagrams. In the drawings, the relationship between the thickness and width of each part, the ratio of the thickness of each part, and relative angles differ from reality. The drawings also include portions with different dimensional relationships and ratios. Illustrations of some constituent elements and the labeling of some components are omitted.

[0021] <First Implementation>

[0022] like Figure 1 and Figure 2 As shown, the endoscope 9 in this embodiment, together with the access sheath 70, processor 86, light source device 87, monitor 88, air supply unit 83, and fluid supply unit 85, constitutes an endoscope system 8. The endoscope 9 is a renal pelvis ureteroscope.

[0023] The endoscope 9 has an insertion section 90, an operating section 91, a universal flexible cable 92, and a connector 93. The insertion section 90 of the endoscope 9, together with the access sheath 70, is inserted into the renal pelvis 100 via a urinary catheter to capture images of the renal pelvis and output image signals.

[0024] The insertion part 90 includes a front end portion 90A, a bent portion 90B disposed at the base end of the front end portion 90A, and a flexible tube 90C disposed at the base end of the bent portion 90B. An imaging unit 21 for capturing images, including an imaging optical system and a CCD image sensor, is disposed at the front end portion 90A. The front end portion 90A has a front opening H80A for a clamp channel 80 that penetrates the insertion part 90. The bent portion 90B is bent by operation of the operating part 91.

[0025] The operating section 91 is equipped with various buttons for operating the endoscope 9. The operating section 91 has an insertion port H80B that serves as an opening for the forceps channel 80. A T-tube 84 is provided in the insertion port H80B.

[0026] As described below, the operation unit 91 has an internal space S91 in which the sensor 60 is disposed. Figure 2 The sensor 60 is used to estimate the intra-organ pressure of the renal pelvis. The sensor 60 is, for example, a pressure sensor on a diaphragm that blocks the opening of a closed space, on which a piezoelectric element is disposed. Due to deformation of the diaphragm, the resistance of the piezoelectric element changes. The sensor 60 detects the pressure applied to the outer surface of the diaphragm based on the change in resistance of the piezoelectric element.

[0027] The access sheath 70 is a flexible tube with an inner diameter larger than the outer diameter of the insertion part 90. The insertion part 90 is inserted into the interior of the access sheath 70. The base of the access sheath 70 is disposed externally.

[0028] The light source device 87, for example, has a white LED. The illumination light emitted by the light source device 87 passes through a light guide 31 inserted into a universal flexible wire 92 and an insertion portion 90 (see reference). Figure 3 The light is guided to the front end 90A to illuminate the subject. The light guide 31 includes multiple optical fibers.

[0029] The endoscope 9 transmits the camera signal output from the camera unit 21 located at the front end 90A of the insertion section 90 to the processor 86 via the signal cable 22. The processor 86 processes the image signal and outputs the endoscope image to the monitor 88. The processor 86 also performs overall control of the endoscope system 8.

[0030] The fluid supply unit 85 supplies a fluid such as saline solution, i.e., perfusion fluid. The perfusion fluid flows into the forceps channel 80 from the opening H84A of the T-tube 84 of the insertion port H80B provided in the operating part 91, and is injected into the renal pelvis 100 from the front opening H80A of the front end 90A. The renal pelvis 100 is filled with perfusion fluid. The perfusion fluid injected into the renal pelvis 100 flows out of the body through the gap between the access sheath 70 and the insertion part 90.

[0031] If the infused volume of perfusion fluid exceeds the outflow volume, the intrarenal pelvic pressure will increase. Therefore, the infused volume of perfusion fluid needs to be appropriately managed based on the intrarenal pelvic pressure.

[0032] like Figure 3 As shown, the internal space S90 of the insertion section 90 is equipped with a signal cable 22, a clamp channel 80, an operation line 32 for bending the bending section 90B, a light guide 31, etc. The endoscope 9 has four operation lines 32 for bending in four directions. In endoscopes with two bending directions, there are two operation lines 32. The signal cable 22, operation line 32, etc., can be installed in their respective tubes or in a multi-lumen tube.

[0033] For example, the internal space S91 of the housing of the operating part 91, which is made of hard resin or the like, communicates with the internal space S90 of the cylindrical insertion part 90, which is made of soft resin and mesh metal or the like.

[0034] The gas supply unit 83 supplies gas, such as air, for estimating the internal pressure of the renal pelvis 100. Although not shown, the liquid supply unit 85 and the gas supply unit 83 are connected to and controlled by the processor 86.

[0035] The endoscope 9 has a first opening H9A at its front end 90A that communicates with the sealed internal space S90 of the insertion part 90. Additionally, the operating part 91 has a second opening H9B that communicates with the sealed internal space S91. The internal space S90 of the insertion part 90 and the internal space S91 of the operating part 91 communicate with each other.

[0036] An air supply pipe for the air supply unit 83 is installed at the second opening H9B of the operating section 91. Gas flowing in from the second opening H9B passes through the internal space S91 of the operating section 91 and the internal space S90 of the insertion section 90, and is released as a bubble into the renal pelvis 100 filled with perfusion fluid from the first opening H9A of the front end 90A. The gas released into the renal pelvis 100, together with the perfusion fluid, is released outside the body through the gap between the access sheath 70 and the insertion section 90.

[0037] A T-tube 84 is installed at the insertion port H80B of the operating section 91. The supply tube of the supply unit 85 is connected to the opening H84A of the side tube of the T-tube 84. The supply volume of the perfusion fluid is adjusted according to the opening and closing angle of the stopcock (not shown). As will be described later, the adjustment of the supply volume can also be performed automatically, for example, by the processor 86.

[0038] The perfusion fluid is injected into the renal pelvis 100 through the forceps channel 80 from the front opening H80A of the front end 90A. Forceps, laser probe and other treatment instruments 89 are inserted into the forceps channel 80 through the opening H84B on the opposite side of the insertion port H80B of the T-tube 84.

[0039] To prevent liquid from entering the internal space S90 of the insertion part 90, the endoscope 9 preferably has a gas-liquid separation membrane 50 between the first opening H9A and the flow path, which allows gas to pass through but not liquid. The gas-liquid separation membrane 50 is, for example, a silicone porous membrane with tiny pores having an outer diameter of less than about 0.5 micrometers.

[0040] Figure 2 The gas-liquid separation membrane 50 shown is disposed on the base end side of the front end portion 90A. The gas-liquid separation membrane 50 may also be disposed on the front end face of the front end portion 90A.

[0041] In endoscope 9, the internal pressure (pressure of the perfusion fluid) of the renal pelvis 100 is not directly measured using a sensor disposed within the renal pelvis 100. Instead, the pressure sensor 60 is mounted on the externally disposed operating unit 91. Furthermore, the sensor 60 does not directly measure the pressure of the perfusion fluid. Instead, the sensor 60 estimates the pressure of the perfusion fluid in the renal pelvis 100 based on the measured pressure of the fluid (gas) within the operating unit 91.

[0042] like Figure 4 As shown, the pressure of the gas supplied from the gas supply unit 83 at a specified pressure and a specified flow rate F (pressure P1 detected by sensor 60) sometimes rises sharply. This is because the internal pressure P0 of the renal pelvis 100 is higher than the pressure P2 of the gas to be released into the renal pelvis 100, and the gas will not be released into the renal pelvis 100. That is, the pressure P1 detected by sensor 60 varies according to the pressure of the perfusion fluid (internal pressure P0) in the renal pelvis 100.

[0043] The pressure of the fluid supplied from the air supply unit 83 is set according to the allowable internal pressure P0. The fluid pressure is, for example, 40 cmH2O.

[0044] The flow rate F of the fluid supplied from the air supply unit 83 is appropriately set. For example, the fluid flow rate F is 5 cm³. 3 / min.

[0045] For example, if the pressure P1 detected by the sensor 60 rises significantly or exceeds a predetermined value PX, the processor 86 controls the liquid supply unit 85 to reduce the amount of perfusion fluid supplied. The processor 86 may also generate a warning in cases of a significant increase in pressure P1. In such situations, the user can adjust the opening and closing angle of, for example, the stopcock of the T-tube 84 based on the warning.

[0046] Pressure P2 is the pressure of the gas inserted into the internal space S90 of the anterior end 90A of the kidney 100. The pressure of the fluid flowing in the flow path varies depending on the pipe resistance, therefore the pressure P2 in the anterior end 90A is different from the pressure P1 in the operating part 91. If the cross-sectional area of ​​the flow path is narrow, the pipe resistance becomes significant.

[0047] In endoscope 9, the gas flow path is the internal space S91 of the operating section 91 and the internal space S90 of the insertion section 90. The cross-sectional areas of internal spaces S91 and S90 are relatively large. Due to the low resistance in the flow path, pressure P1 and pressure P2 are approximately the same. The endoscope system 8 with endoscope 9 can accurately estimate the intrarenal pressure P0 of the renal pelvis 100. Therefore, the endoscope system 8 can appropriately manage the perfusion fluid injection volume based on the estimated intrarenal pelvis pressure.

[0048] In endoscope 9, sensor 60 is not located at the front end 90A, but rather at the operating part 91. Because the front end 90A of endoscope 9 has a narrow diameter, it is minimally invasive.

[0049] It should be noted that although the tubing resistance increases, a dedicated tube can still be fitted to the endoscope as a gas flow path for estimating the internal pressure of the renal pelvis 100. However, in endoscope 9, a wide space not used in conventional endoscopes is used as the flow path, so a dedicated tube is not required. That is, the inner surfaces of the gas flow path are the inner wall 91S of the operating part 91 and the inner wall 90S of the insertion part 90. Endoscope 9, which does not require a dedicated flow path tube, is minimally invasive because the insertion part 90 has a small diameter.

[0050] <Modifications of the First Embodiment>

[0051] like Figure 5 As shown, the endoscope 9A and endoscope system 8A of the modified example of the first embodiment are similar to the endoscope 9 and endoscope system 8 of the first embodiment, and have the same effects. Therefore, in the following description, the same reference numerals are used to mark the components that have the same function as the endoscope 9 and endoscope system 8, and the description is omitted. In addition, the structure of the front end of the endoscope 9A is the same as that of the endoscope 9, therefore... Figure 5 The front end is not shown in the diagram.

[0052] For example, the inner surface of the internal space S92 of the general-purpose flexible cord 92 is formed by the inner wall 92S of the cylindrical general-purpose flexible cord 92, which is a tube made of soft resin and mesh metal. Signal cables 22, light guides 31, etc., are disposed in the internal space S92 of the general-purpose flexible cord 92. The internal space S92 of the general-purpose flexible cord 92 communicates with the internal space S91 of the housing of the operating part 91, which is made of rigid resin.

[0053] In the endoscope 9A, fluid is supplied from the air supply unit 83 to the light source device 87, which includes the light source 87A. The fluid that flows into the internal space S92 of the universal cable 92 via the connector 93 passes through the internal space S91 of the operation part 91 and the internal space S90 of the insertion part 90, and is released as a bubble from the first opening H9A of the front end 90A into the renal pelvis 100 filled with perfusion fluid.

[0054] Since no air supply tube is provided in the operating section 91, the endoscope 9A and the endoscope system 8A have good operability. In the endoscope 9A and the endoscope system 8A, the fluid flows into the internal space S91 of the operating section 91 through the internal space S92 of the general-purpose flexible cord 92 with a large cross-sectional area, so the pressure loss in the general-purpose flexible cord 92 is small.

[0055] <Second Implementation>

[0056] The endoscope 9B and endoscope system 8B of the second embodiment are similar to the endoscope 9 and endoscope system 8 of the first embodiment and have the same effects. Therefore, in the following description, the same reference numerals are used to mark the components that have the same function as the endoscope 9 and endoscope system 8, and the description is omitted.

[0057] In endoscope 9B, the fluid used to estimate the internal pressure of renal pelvis 100 is an irrigation fluid. As already described, the irrigation fluid flow path is formed by a forceps channel 80B, which has an insertion port H80B in the operating part 91 and a front opening H80A in the front end 90A.

[0058] like Figure 6 As shown, the clamp channel 80B, made of an elastomer, has a detection area A80 with a relatively thin wall in the operating part 91. The sensor 60B is a strain gauge, for example, made of a piezoelectric element, wound around the outer periphery of the detection area A80.

[0059] The outer diameter of the forceps channel 80B varies according to the pressure of the perfusion fluid. The outer diameter of the thinner-walled detection area A80 varies particularly greatly according to the pressure of the perfusion fluid. The resistance of the sensor 60B changes as the outer diameter of the forceps channel 80B changes. The pressure detected by the sensor 60B is the pressure of the perfusion fluid in the forceps channel 80B within the operating unit 91. The pressure detected by the sensor 60B varies according to the pressure of the perfusion fluid in the renal pelvis 100 (intra-renal pelvic pressure). In the endoscope system 8B, the supply of perfusion fluid is controlled based on the pressure detected by the sensor 60B, thereby appropriately adjusting the intra-renal pelvic pressure.

[0060] Because the sensorless front end 90A is narrow, the endoscope 9B and endoscope system 8B are low-invasive.

[0061] In the above embodiments and modifications, a flexible endoscope and endoscope system for the renal pelvis ureter, where the organ whose internal pressure is estimated is the renal pelvis, have been described as examples. The endoscope in the embodiments of the present invention can be, for example, a digestive organ endoscope or a rigid endoscope. Furthermore, the endoscope in the embodiments of the present invention can also be an industrial endoscope or a wireless endoscope without a universal flexible cord.

[0062] The present invention is not limited to the above-described embodiments and variations. Various changes, modifications, and combinations can be made without altering the spirit of the present invention.

Claims

1. An endoscope comprising: An insertion part is provided with a camera unit at its front end and is inserted into an organ of the subject. The insertion part has a first internal space and the front end has a first opening that communicates with the first internal space. An operating part, disposed at the base end of the insertion part, the operating part having a second internal space communicating with the first internal space; and A sensor, disposed in the second internal space of the operating unit, detects the pressure of gas flowing through a flow path that extends from the second internal space to the first opening of the front end, and allows gas flowing into the second internal space to flow out through the first opening.

2. The endoscope according to claim 1, wherein, The inner surface of the flow path is the inner wall of the operating part and the inner wall of the insertion part.

3. The endoscope according to claim 2, wherein, The endoscope has a second opening that communicates with the flow path. The gas flows into the operating section through the second opening.

4. The endoscope according to claim 2, wherein, The endoscope also includes a universal flexible cable disposed at the base of the operating section. The gas flows into the operating section through the internal space of the universal flexible cord.

5. An endoscope comprising: The insertion part is equipped with a camera unit at its front end and is inserted into the organ of the subject. An operating part, which is disposed at the base end of the insertion part; and A sensor, disposed in the operating unit, detects the pressure of the fluid in a flow path that extends from the operating unit to a third opening in the front end, and allows the fluid flowing into the operating unit to flow out through the third opening. The fluid is an irrigation fluid. The flow path is formed by a clamp channel, which has an insertion port in the operating part and the third opening at the front end. The sensor is located on the outer periphery of the clamp channel to detect the pressure of the injection fluid flowing through the clamp channel.

6. The endoscope according to claim 5, wherein, The perfusion fluid injected into the organ flows out of the body through the gap between the access sheath into which the insertion part is inserted and the insertion part.

7. The endoscope according to claim 6, wherein, A gas-liquid separation membrane that allows gas to pass through but prevents liquid from passing through is provided between the third opening and the flow path.

8. The endoscope according to claim 5, wherein, The clamp channel has a detection area with a relatively thin wall. The sensor is a strain gauge wound around the outer periphery of the detection area.

9. An endoscope system comprising: The endoscope as described in claim 5; and A processor that controls the flow rate of the perfusion fluid based on the pressure detected by the sensor.

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