Endoscope and endoscope system

Abstract

An endoscope (2) has an insertion section (21) inserted into a subject, and a suction passage (12) that simultaneously sucks a broken stone and a liquid. The suction passage (12) has a passage main body (12d) inserted into the insertion section (21), and a small-diameter passage section (12e) provided on a front end side of the passage main body (12d) and having an inner diameter smaller than that of the passage main body (12d). When the inner diameter of the passage main body is set as R1 and the inner diameter of the small-diameter passage section is set as R2, the suction passage is configured to satisfy the following relationship R1 / R2>1.27.

Description

Technical Field

[0001] This invention relates to an endoscope and an endoscope system that simultaneously aspirates broken stones and fluid via a suction channel. Background Technology

[0002] In recent years, various techniques have been proposed for breaking stones into small fragments and recycling them when removing stones from organs such as the kidneys of a patient.

[0003] One method for breaking up stones is to generate laser light using a laser device. A ureteroscope is inserted into the organ being examined, and a laser probe connected to the laser device is inserted through the treatment instrument channel of the ureteroscope. The laser light is then directed at the stone through the laser probe, thereby breaking up the stone.

[0004] For example, Japanese Patent Publication No. 2018-500986 describes a technique for inserting a laser probe for breaking up stones into a suction port in a medical device. This medical device includes: a camera and a lighting device disposed on the front end of a tube; a suction port having an opening on the front end of the tube; and multiple water inlets disposed on the side of the tube. Here, the inner diameter of the suction port is constant from the front end to the base end, and the outer diameter of the laser probe is configured to be smaller than the inner diameter of the suction port, forming a gap between the suction port and the laser probe. Stones broken up by laser irradiation from the laser probe, along with liquid supplied from the water inlets, are recovered through the gap between the suction port and the laser probe.

[0005] However, the position of the central axis of the laser probe within the suction channel (suction port) is not always aligned with the central axis of the suction channel; sometimes it is offset relative to the suction channel along a portion of its length. In such cases, a narrowing gap may sometimes occur between the suction channel and the laser probe, and stones drawn from the front end can clog this narrow gap.

[0006] The present invention was made in view of the above circumstances, and its object is to provide an endoscope and endoscope system that reduce blockage in the suction channel. Summary of the Invention

[0007] Methods for solving problems

[0008] An endoscope according to one aspect of the present invention includes: an insertion portion for insertion into a subject; and a suction channel, wherein the suction channel comprises: a channel body inserted into the insertion portion; and a small-diameter channel portion disposed at the front end side of the channel body, having an inner diameter smaller than the inner diameter of the channel body, and having a channel opening at the front end face of the insertion portion. The suction channel simultaneously aspirates broken stones and fluid from the channel opening. When the inner diameter of the channel body is set to R1 and the inner diameter of the small-diameter channel portion is set to R2, the suction channel is configured to satisfy the following relationship.

[0009] R1 / R2>1.27.

[0010] An endoscope system according to one aspect of the present invention includes an endoscope and a stone fragmentation device, wherein the endoscope includes: an insertion portion for insertion into a subject; and a suction channel, wherein the suction channel includes: a channel body inserted into the insertion portion; and a small-diameter channel portion disposed at the front end side of the channel body, having an inner diameter smaller than the inner diameter of the channel body, and having a channel opening at the front end face of the insertion portion, the suction channel simultaneously aspirating fragmented stones and fluid from the channel opening, and the stone fragmentation device includes: a probe protruding from the insertion portion to fragment the stones; and a generator supplying energy to the probe, wherein when the inner diameter of the channel body is set to R1 and the inner diameter of the small-diameter channel portion is set to R2, the suction channel is configured to satisfy the following relationship.

[0011] R1 / R2>1.27. Attached Figure Description

[0012] Figure 1 This is a diagram illustrating a structural example of an endoscope system according to a first embodiment of the present invention.

[0013] Figure 2 This is a diagram illustrating a structural example of the endoscope in the first embodiment described above.

[0014] Figure 3 This is a perspective view showing the front end of an endoscope with a laser probe inserted in the first embodiment described above.

[0015] Figure 4 This is a diagram showing the front end of the insertion portion of the endoscope after the laser probe has been removed in the first embodiment described above.

[0016] Figure 5 This is a cross-sectional view showing the structure of the suction channel and laser probe in the first embodiment described above.

[0017] Figure 6 This is a front view showing the structure of the front end of the insertion portion of the endoscope in the first embodiment described above.

[0018] Figure 7 This is a diagram illustrating an example in the first embodiment described above where a stone attracted through the narrow-diameter channel portion blocks the main body of the channel when the laser probe is not inserted into the suction channel.

[0019] Figure 8 This is a bar chart illustrating an example where, in the first embodiment described above, the frequency of stone blockage varies depending on the ratio of the inner diameter of the channel body to the inner diameter of the small-diameter channel section, when the laser probe is not inserted into the suction channel.

[0020] Figure 9 This diagram illustrates the effect of the laser probe, when inserted into the suction channel, in the first embodiment described above, on eliminating blockage of the stone between the small-diameter channel portion and the front-end side-shaped portion.

[0021] Figure 10 This is a cross-sectional view showing the structure of the attraction channel and laser probe in the second embodiment of the present invention.

[0022] Figure 11 This is a front view showing the structure of the front end of the insertion portion of the endoscope in the second embodiment described above.

[0023] Figure 12 This is a cross-sectional view showing the structure of the attraction channel and laser probe in an associated embodiment of the present invention.

[0024] Figure 13 This is a front view showing the structure of the front end of the insertion portion of the endoscope in the above-described associated embodiment. Detailed Implementation

[0025] Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings. However, the present invention is not limited to the embodiments described below.

[0026] Furthermore, in the accompanying drawings, identical or corresponding elements are appropriately labeled with the same reference numerals. It should also be noted that the drawings are schematic; for the sake of simplicity, the length relationships, length ratios, and quantities of elements within a drawing may sometimes differ from reality. Moreover, among multiple drawings, there may sometimes be sections where the length relationships or ratios differ from each other.

[0027] [First Implementation Method]

[0028] Figures 1 to 9 This illustrates a first embodiment of the present invention. Figure 1 This is a diagram showing a structural example of an endoscope system 1.

[0029] like Figure 1 As shown, the endoscope system 1 of this embodiment includes an endoscope 2, an endoscope control device 3, a monitor 4, a laser system 5 (stone fragmentation device) and a pump system 6 (liquid delivery / suction device).

[0030] Endoscope 2 is a device for observing and treating a subject. Endoscope 2 includes a slender insertion part 21 that is inserted into the subject, an operating part 22 connected to the base of the insertion part 21, and a universal cable 23 extending from the operating part 22. In addition, assuming that the subject into which the insertion part 21 is inserted is a living organism such as a human or animal, but is not limited to this, it can also be a non-living object such as machinery or a building.

[0031] Figure 2 This is a diagram showing a structural example of endoscope 2.

[0032] like Figure 2 As shown, the insertion part 21 has a front end 21a, a curved part 21b and a tubular part 21c in sequence from the front end toward the base end.

[0033] The front end 21a is equipped with an observation system and a lighting system. The observation system includes an observation window 13 (see reference). Figure 6 The endoscope 2 (etc.) includes an objective lens optical system and, in the case of an electronic endoscope, an image sensor; and in the case of an optical endoscope, an image guide. Hereinafter, we will assume that the endoscope 2 is an electronic endoscope. The image sensor is connected to a signal line and may be, for example, an image sensor such as a CMOS or CCD. Additionally, the viewing window 13 can also function as the front lens of the endoscope optical system.

[0034] The lighting system, for example, has an illumination window 14 that also functions as an illumination optics system (see reference). Figure 6 (etc.) and light guides. The light guides are configured, for example, as fiber bundles formed by combining optical fibers. The signal lines and light guides connected to the imaging element are disposed in the insertion part 21, the operation part 22 and the general cable 23, and are connected to the endoscope control device 3.

[0035] Figure 3 This is a perspective view showing the front end portion 21a of the endoscope 2 through which the laser probe 52 is inserted. Figure 4 This is a diagram showing the front end 21a of the insertion part 21 of the endoscope 2 after the laser probe 52 has been removed.

[0036] like Figure 3 and Figure 4 As shown, a liquid delivery channel 11 for conveying liquid and a suction channel 12 that also serves as a treatment device channel are inserted into the insertion portion 21. The liquid delivery channel 11 has, for example, a constant inner diameter, and a channel opening 11a is provided on the front end face 21a1 of the front end portion 21a. The suction channel 12 has a channel body 12d that is inserted into the insertion portion 21 and a small-diameter channel portion 12e provided on the front end side of the channel body 12d.

[0037] The narrow-diameter channel section 12e has a channel opening 12a (disposal device opening) on ​​the front end face 21a1 of the front end portion 21a. Whether Figure 3 When the laser probe 52 shown is inserted into the suction channel 12, it is still Figure 4After the laser probe 52 is pulled out of the suction channel 12, the suction channel 12 simultaneously draws in the broken stones and liquid from the channel opening 12a. The bending portion 21b is connected to the base end side of the front end portion 21a, and is configured to be able to bend in two directions or in four directions (up, down, left, and right). When the bending portion 21b bends, the direction of the front end portion 21a changes, and the observation direction of the observation system and the illumination direction of the illumination system change. In addition, the bending portion 21b is also bent to improve the insertability of the insertion portion 21 within the subject.

[0038] The tubular portion 21c is a tubular section that connects the base end of the curved portion 21b to the front end of the operating portion 22. The tubular portion 21c can be a rigid form where the insertion portion 21 does not bend, or a flexible form where the insertion portion 21 bends according to the shape of the inserted object. Endoscopes with a rigid insertion portion are generally called rigid endoscopes, and endoscopes with a flexible insertion portion are generally called flexible endoscopes. For example, in the medical field, rigid and flexible endoscopes are defined as ISO 8600-1:2015.

[0039] The operation section 22 is connected to the base end of the insertion section 21 and is the part used to perform various operations related to the endoscope 2 by hand. The operation section 22 includes, for example, a gripping part 22a, a bending operating lever 22b, multiple operating buttons 22c, a channel opening 11b on the base end of the liquid delivery channel 11, a channel opening 12b on the base end of the suction channel 12, and a suction tube connector 12c for the suction channel 12.

[0040] The holding part 22a is the part where the operator holds the endoscope 2 with their palm.

[0041] The bending lever 22b is an operating device for performing the following operation: bending the bending part 21b by using the thumb of the hand holding the handle 22a.

[0042] The multiple operation buttons 22c include, for example, a liquid delivery button and a suction button. The liquid delivery button is used to deliver liquid to the front end 21a side via the liquid delivery channel 11. The suction button is used to suction from the front end 21a side via the suction channel 12. Additionally, the multiple operation buttons 22c may also include, for example, push-button switches for performing operations associated with the camera (such as release operations).

[0043] The channel opening 11b on the base end side of the liquid delivery channel 11 is provided on one side of the front end of the gripping part 22a. A liquid delivery tube 63 is connected to the channel opening 11b.

[0044] The channel opening 12b on the base side of the suction channel 12 is located on the other side of the front end of the holding part 22a. A protective tube 53 is inserted into the channel opening 12b of the suction channel 12, which also serves as a passage for a treatment device. The protective tube 53 prevents breakage of the laser fiber of the laser probe 52. Furthermore, the suction channel 12 is used to insert various treatment devices. Therefore, a treatment device such as pliers can be inserted into the suction channel 12 instead of the laser probe 52.

[0045] In addition, the suction channel 12 simultaneously aspirates fluid and broken stones from the body being examined. A first suction tube 64 is connected to the suction tube connector 12c located near the channel opening 12b on the base side of the suction channel 12.

[0046] The universal cable 23 extends from the side of the base end of the operating part 22 and is connected to the endoscope control device 3.

[0047] The endoscope control device 3 also serves as an image processing device and a light source device. It controls the endoscope 2, processes the camera signals obtained from the endoscope 2, and supplies illumination light to the endoscope 2.

[0048] The endoscope control device 3 includes: multiple light sources that emit white light or special observation light; a light source control circuit that controls the light sources; and an optical system that converges the light emitted from the light sources onto the incident end of a light guide. The light source can be any device that emits illumination light; it can be any light source such as an LED (Light Emitting Diode), laser, xenon, or halogen light source, or a combination of multiple light sources.

[0049] Alternatively, the image processing device and the light source device can be configured as separate devices. Furthermore, a structure in which illumination light is emitted by a light-emitting element disposed at the front end 21a can be used instead of a structure in which illumination light is supplied from the endoscope control device 3 to the endoscope 2.

[0050] The components of the endoscope control device 3, which perform light source control, image processing, and various other controls, are configured such that, for example, a processor including an ASIC (Application Specific Integrated Circuit) or FPGA (Field Programmable Gate Array) containing a CPU (Central Processing Unit) reads a computer program (software) stored in a computer-readable non-transitory storage device such as ROM (Read-Only Memory) (or HDD (Hard Disk Drive), SSD (Solid State Drive), or disk-based recording media), expands it in RAM (Random Access Memory), and executes it, thereby realizing all or part of the functions of each component. However, this is not the only option; for example, the endoscope control device 3 may also be configured to realize all or part of the functions of each component through dedicated electronic circuitry.

[0051] By connecting the universal cable 23 to the connector seat of the endoscope control device 3, the endoscope 2 is electrically and optically connected to the endoscope control device 3.

[0052] Illumination light emitted from the endoscope control device 3, which also functions as a light source, is transmitted through a light guide and illuminates the subject from the illumination window 14 at the front end 21a. The reflected light from the subject, which has been illuminated, passes through the observation window 13 and is imaged on the imaging element via the objective lens optical system.

[0053] The endoscope control device 3 sends drive signals and power to the imaging element. The imaging element captures an optical image of the subject according to the drive signals, generating an image signal. The imaging element captures images sequentially, for example, frame by frame, generating an image signal associated with multiple frames of dynamic images. The image signal is transmitted to the endoscope control device 3 via a signal line.

[0054] The endoscope control device 3 receives the camera signal from the camera element and performs various image processing operations such as depixelation, noise correction, color correction, contrast correction, and gamma correction to generate a displayable image signal. The endoscope control device 3 can also overlay various information such as text information and guidance information onto the image signal.

[0055] The image signal generated by the endoscope control device 3 is output to the monitor 4. The monitor 4 is a display device that receives the image signal from the endoscope control device 3 and displays the endoscopic image.

[0056] The laser system 5 is a stone-breaking device comprising a laser device body 51 and a laser probe 52. The laser device body 51 is a generator that produces laser energy and supplies it to the laser probe 52, which breaks up stones (urinary tract stones) located in the kidneys, ureters, bladder, urethra, etc. The laser probe 52 is equipped with a laser optical fiber for transmitting the laser. The probe tip 52a of the laser probe 52 extends from the channel opening 12a on the front side of the suction channel 12, and generates laser energy through the laser device body 51. Thus, the laser transmitted by the laser probe 52 irradiates the stones in the patient's body from the probe tip 52a, breaking up the stones.

[0057] Furthermore, while a laser system 5 is listed as an example of a stone-breaking device in this embodiment, it is not limited to this; any device capable of breaking stones is acceptable. For example, when using ultrasonic waves to break stones, instead of the laser probe 5 and the laser device body 51, an ultrasonic probe and an ultrasonic device that supplies energy to the ultrasonic probe can be used as the stone-breaking device.

[0058] The pump system 6 includes: a pump body 61, which has a liquid delivery pump 6a, a first suction pump 6b and a second suction pump 6c; a liquid delivery tank 62; a liquid delivery pipe 63; a first suction pipe 64; a first filter 65; a second filter 66; a second suction pipe 67; and a waste tank 68.

[0059] The delivery tank 62 stores the liquid to be delivered into the body of the patient. The liquid stored in the delivery tank 62 is, for example, physiological saline.

[0060] The liquid delivery tank 62 is connected to the liquid delivery pump 6a via the liquid delivery pipe 63. The liquid delivery pipe 63, which is located at the front end of the liquid delivery pump 6a, is connected to the channel opening 11b at the base end of the liquid delivery channel 11.

[0061] When the liquid delivery pump 6a is working, the liquid in the liquid delivery tank 62 is transported through the liquid delivery pipe 63 and discharged into the body of the test subject through the channel opening 11a on the front side of the liquid delivery channel 11.

[0062] When the first suction tube 64 is connected to the suction tube connector 12c, it communicates with the interior of the suction channel 12. Even when the laser probe 52 is inserted into the suction channel 12, suction can still be performed using the first suction tube 64 because there is a gap between the laser probe 52 and the suction channel 12.

[0063] The first suction tube 64 is connected to the second filter 66 via the first filter 65 and the first suction pump 6b. The first filter 65 and the second filter 66 are instruments for filtering stones and mucous membranes aspirated from the subject. For example, the first filter 65 is used to collect stones. The first filter 65 is installed, for example, at the front end of the handle 22a in the operating part 22 of the endoscope 2 (however, it is not limited to this configuration).

[0064] One end of the second suction tube 67 is connected to the second filter 66, and the other end is connected to the waste tank 68 via the second suction pump 6c.

[0065] The first suction pump 6b and the second suction pump 6c operate in conjunction with each other. When the laser probe 52 is inserted into the suction channel 12 through the channel opening 12a, it simultaneously draws in stones and fluid from the subject body between the small-diameter channel portion 12e and the front end side-shaped portion 52c. At the same time, the liquid delivery pump 6a also operates in conjunction with this, thereby simultaneously delivering liquid into the subject body through the liquid delivery channel 11 and drawing in the fluid from the subject body through the suction channel 12. The liquid discharged from the liquid delivery channel 11 circulates within the subject body, and the broken stones are transported along with the flow, thereby improving the stone recovery efficiency of the pump system 6.

[0066] Figure 5 This is a cross-sectional view showing the structure of the attraction channel 12 and the laser probe 52. Figure 6 This is a front view showing the structure of the front end portion 21a of the insertion part 21 of the endoscope 2.

[0067] The channel body 12d, for example, has a constant inner diameter R1 from the channel opening 12b on the base side toward the front end side (see reference). Figure 5 The small-diameter channel portion 12e, located at the front end of the channel body 12d, has an inner diameter R2 (R2 < R1) smaller than the inner diameter R1 of the channel body 12d.

[0068] exist Figure 4 When the laser probe 52 is not inserted into the suction channel 12, depending on the ratio of the inner diameter R1 of the channel body 12d to the inner diameter R2 of the small diameter channel portion, R1 / R2 (>1), the stones CS that are attracted together with the liquid from the channel opening 12a are either blocked or transported within the channel body 12d without being blocked.

[0069] Although the narrow-diameter channel portion 12e has an inner diameter R2 that is smaller than the inner diameter R1 of the channel body 12d, the reason for the blockage when the inner diameter is smaller than R1 / R2 is that the attracted stones CS sometimes include elongated stones CS.

[0070] Figure 7This is a diagram illustrating an example of a stone CS being drawn through the narrow-diameter channel portion 12e and blocking the channel body 12d when the laser probe 52 is not inserted into the suction channel 12.

[0071] like Figure 7 As shown in column A, in the broken stone CS, the length of the longest axis is set as r1, and the length of the longest diameter among the diameters perpendicular to the longest axis is set as r2. As an example, when the stone CS is an ellipsoid with the lengths of the three orthogonal diameters set as a, b, and c (a < b < c), it is equivalent to r1 = c and r2 = b.

[0072] like Figure 7 As shown in column B, if r2 < R2, then the stone CS can pass through the small diameter channel 12e and be attracted into the interior of the channel body 12d.

[0073] However, if the stone CS further satisfies r1>R1, such as Figure 7 As shown in column C, the CS stone sometimes gets stuck on the inner wall inside the channel body 12d and cannot move within the channel body 12d.

[0074] Therefore, as Figure 7 As shown in column D, for stones CS stuck on the inner wall of the channel body 12d, subsequent stone CS accumulation may cause blockage in the suction channel 12.

[0075] Figure 8 This is a bar chart illustrating the different frequencies of stone blockage based on the ratio of the inner diameter of the channel body 12d to the inner diameter of the small-diameter channel portion 12e when the laser probe 52 is not inserted into the suction channel 12. Figure 8 The experimental results show that the number of times a blockage occurs was determined by making the ratio of the inner diameter R1 of the main channel body 12d to the inner diameter R2 of the smaller channel section different.

[0076] In addition, Figure 8 In the diagram, the dashed shaded areas indicate the number of times a blockage could be eliminated by reverse flow, while the solid shaded areas indicate the number of times a blockage could not be eliminated by reverse flow.

[0077] First, when R1 / R2 > 1.36 (range 1), the number of blockages is 0. Therefore, the attracted stones (CS) are transported with almost no blockage within the channel body for 12 days.

[0078] Next, in the case where 1.27 < R1 / R2 < 1.36 (range 2), blockage occasionally occurs. However, the blockage that occurs is one that can be eliminated by using some method to reverse the flow of the broken stone CS towards the front end.

[0079] One example of a method to cause the stone CS to flow backwards towards the front end is to change the connection between the delivery channel 11 and the suction channel 12 midway, thereby delivering fluid to the suction channel 12. Therefore, the pump connected to the suction channel 12 is not limited to suction pumps 6b and 6c; sometimes it is also a delivery pump 6a. Another example of a backflow method is to install a solenoid valve midway through the suction channel 12, opening the valve only briefly to open the suction channel 12 and achieve atmospheric pressure. However, this is not a limitation; appropriate methods can also be used to cause the stone CS to flow backwards.

[0080] Furthermore, in the case where 1 < R1 / R2 < 1.27 (range 3), blockage occurs at a higher frequency than in the case of (range 2). The blockages occurring in the case of (range 3) include not only blockages that can be eliminated by backflow, but sometimes also blockages that cannot be eliminated by backflow. In the case of blockages that cannot be eliminated by backflow, it is necessary to take measures such as stopping suction and using a syringe to pressurize the suction channel 12.

[0081] exist Figure 8 In the experimental results shown, when R1 / R2 > 1.36 (range 1), the stone CS can be transported within the channel body within 12d without blockage because if laser is used to break up the stone, the probability that the broken stone CS will have a shape that simultaneously satisfies r2 < R2 and r1 > R1 is extremely low. That is, the value of 1.36, which is the lower limit for the inner diameter ratio of the stone CS to almost not cause blockage, is a value determined experimentally based on the shape of the stone CS broken by laser.

[0082] Furthermore, the laser probe 52 includes a treatment device body 52b with an outer diameter R3 (R3 < R2) and a front-end side shape portion 52c with an outer diameter R4 (R4 < R2). In this embodiment, the laser probe 52 is configured such that the outer diameter of the front-end side shape portion 52c is larger than the outer diameter of the treatment device body 52b, satisfying R4 > R3. Additionally, in the illustrated example, the probe tip 52a, which is closer to the front end than the front-end side shape portion 52c, has, for example, the same outer diameter R3 as the treatment device body 52b (however, this structure is not limited to this).

[0083] When the laser probe 52 is irradiating the stones in the body of the subject with laser light from the probe tip 52a, the treatment instrument body 52b is inserted into the channel body 12d, and the front end side shape portion 52c is inserted into the small diameter channel portion 12e. That is, when the laser probe 52 extends from the front end face 21a1 of the front end 21a to a length suitable for irradiating the laser, the front end side shape portion 52c is provided at a position corresponding to the small diameter channel portion 12e.

[0084] At this point, the attraction channel 12 and the laser probe 52 are configured to satisfy the following relationship:

[0085] R1-R3≥2(R2-R4)…(1).

[0086] (R1-R3) / 2 represents the minimum value of the widest gap among the gaps generated around the treatment device body 52b and the channel body 12d. For example, when the outer surface of the treatment device body 52b contacts the inner surface of the channel body 12d, the narrowest gap 0 and the widest gap (R1-R3) on the opposite circumferential side of the contacting portion are generated. Generally, when the narrowest gap is set to R0 (0≤R0≤{(R1-R3) / 2}), the widest gap is {(R1-R3)-R0}. Moreover, when the narrowest gap is set to R0=(R1-R3) / 2, the widest gap is the same as the narrowest gap, which is (R1-R3) / 2. Thus, (R1-R3) / 2 is the minimum value of the widest gap.

[0087] Furthermore, (R2-R4) represents the maximum diameter of the stone that can pass between the narrow-diameter channel portion 12e and the front-end side-shaped portion 52c (assuming the stone is spherical). Therefore, equation (1) indicates that even if a stone of the maximum diameter that can pass through the channel opening 12a enters the suction channel 12, there is a flow path with a gap of more than the maximum diameter in the gap between the treatment device body 52b and the channel body 12d, which can attract the stone without clogging.

[0088] Figure 9 This diagram illustrates the effect of inserting the laser probe 52 into the suction channel 12 to eliminate the blockage of stones between the small-diameter channel portion 12e and the front-end side-shaped portion 52c.

[0089] Stones with a diameter greater than (R2-R4) / 2 may sometimes block the gap between the small-diameter channel portion 12e and the front-end side shape portion 52c or the front end of the channel opening 12a. In particular, stones with a diameter greater than (R2-R4) cannot pass through the gap between the small-diameter channel portion 12e and the front-end side shape portion 52c, thus causing blockage.

[0090] The laser probe 52 is capable of moving along the axial direction 21o of the insertion portion 21 within the suction channel 12. Therefore, even if a blockage occurs between the small-diameter channel portion 12e and the front-end shaped portion 52c, the laser probe can still move within the insertion portion 21. Figure 5 The laser probe 52 is moved by pressing along the axial direction 21° at the position shown, as indicated. Figure 9 As shown, the main body 52b of the treatment device is inserted into the narrow-diameter channel 12e. Then, the laser probe 52 is pulled back. Figure 5 The action is shown in the image. Alternatively, you can perform a pull-back and press-forward motion instead of a press-back and pull-back motion.

[0091] The flow path between the narrow-diameter channel portion 12e and the front-end side shape portion 52c is narrower than the flow path between the channel body 12d and the treatment device body 52b. Therefore, when the laser probe 52 moves back and forth, if the stone trapped between the narrow-diameter channel portion 12e and the front-end side shape portion 52c moves to the flow path between the channel body 12d and the treatment device body 52b, it will not become blocked and will be attracted away.

[0092] In addition, by moving the front-end side shape portion 52c of the laser probe 52 forward, the stone between the channel opening 12a and the front-end side shape portion 52c on the front-end side leaves the front-end face 21a1 of the endoscope 2 and circulates again in the body being examined.

[0093] By performing one or more back-and-forth movements of the laser probe 52 along the axial direction 21°, the blockage caused by the stones can be eliminated. Furthermore, for stones that cannot pass through the gap between the narrow-diameter channel portion 12e and the front-end side-shaped portion 52c, further laser irradiation can be used to break them up.

[0094] In addition, the forward and backward movement of the laser probe 52 can be performed by the surgeon's operation, but an additional sliding mechanism can also be set up to perform it mechanically.

[0095] Furthermore, the above description uses the case where the treatment device is the laser probe 52 as an example, but treatment devices other than the laser probe 52 can also be configured to satisfy equation (1) above. For example, when the liquid delivery channel 11 is omitted and the liquid delivery tube 63 is inserted into the suction channel 12 to deliver liquid, the liquid delivery tube 63, as the treatment device for delivering liquid, can also be configured to satisfy equation (1).

[0096] According to this first embodiment, the suction channel 12 has a channel body 12d and a narrow-diameter channel portion 12e, the narrow-diameter channel portion 12e having an inner diameter smaller than that of the channel body 12d. In particular, the suction channel 12 and the treatment device (laser probe 52, etc.) are configured in a manner that satisfies equation (1), so that the stones suctioned from the channel opening 12a can be transported within the channel body 12d without obstruction. Thus, the endoscope 2 and endoscope system 1 according to this embodiment can reduce obstruction within the suction channel 12.

[0097] In addition, by providing a front-end side shape portion 52c that satisfies R4 > R3 in the treatment device (laser probe 52, etc.), blockage in the suction channel 12 can be reduced more reliably.

[0098] By moving the treatment device back and forth, even if a stone blocks the gap between the narrow channel section 12e and the front end shape section 52c or the front end of the channel opening 12a, it can be easily removed.

[0099] By providing a suction tube connector 12c in the suction channel 12, the suction tube 64 can be connected simply and reliably.

[0100] By irradiating the stone with a laser from the laser probe 52 inserted into the suction channel 12, the stone can be accurately broken under the observation of the endoscope 2.

[0101] Furthermore, by using the suction channel 12 as a treatment device channel, the diameter of the insertion part 21 can be reduced compared to the case where the treatment device channel and the suction channel 12 are set separately.

[0102] [Second Implementation]

[0103] Figure 10 and Figure 11 The second embodiment of the present invention is shown. Figure 10 This is a cross-sectional view showing the structure of the attraction channel 12 and the laser probe 52. Figure 11 This is a front view showing the structure of the front end portion 21a of the insertion section 21 of the endoscope 2. In the second embodiment, the same reference numerals are used for the same parts as in the first embodiment, and descriptions are omitted as appropriate; the main differences are explained.

[0104] In this embodiment, the front end side shape portion 52c' of the laser probe 52 inserted into the small diameter channel portion 12e has the same outer diameter as the treatment device body 52b, satisfying R4=R3, and equation (1) is expressed as equation (2) below.

[0105] R1-R3≥2(R2-R3)…(2)

[0106] The meaning of equation (2) is the same as that in equation (1). The minimum value (R1-R3) / 2 of the widest gap generated between the channel body 12d (inner diameter R1) and the laser probe 52 (outer diameter R3) is greater than the maximum diameter (R2-R3) of the stone that can pass between the small diameter channel part 12e (inner diameter R2) and the laser probe 52.

[0107] In addition, the treatment device other than the laser probe 52 can also be configured to satisfy equation (2), which is also the case in this embodiment.

[0108] According to this second embodiment, the same effect as the first embodiment is achieved, and the same effect as the first embodiment can be obtained even without providing a large-diameter portion on the front end side of the treatment device (laser probe 52, etc.). Therefore, a treatment device of a special shape is not required, and a general-purpose treatment device can be used.

[0109] [Related Implementation Methods]

[0110] Figure 12 and Figure 13Embodiments related to the present invention are shown. Figure 12 This is a cross-sectional view showing the structure of the attraction channel 12 and the laser probe 52. Figure 13 This is a front view showing the structure of the front end portion 21a of the insertion section 21 of the endoscope 2. In the relevant embodiments, the same reference numerals are used for the same parts as in the first and second embodiments, and descriptions are omitted where appropriate; the main differences are explained.

[0111] In this related embodiment, the small-diameter channel portion 12e is not provided in the suction channel 12 (therefore, R2 = R1), and the outer diameter of the front end side shape portion 52c of the laser probe 52 is larger than the outer diameter of the treatment device body 52b, satisfying R4 > R3. In this case, equation (1) is expressed as equation (3) below.

[0112] R1-R3≥2(R1-R4)…(3)

[0113] The meaning of equation (3) is the same as that in equation (1). The minimum value (R1-R3) / 2 of the widest gap generated between the suction channel 12 (inner diameter R1) and the probe body 52b (outer diameter R3) is greater than or equal to the maximum diameter (R1-R4) of the stone that can pass between the suction channel 12 and the front end side shape part 52c (outer diameter R4).

[0114] According to this associated implementation, it is possible to achieve the same effect as the first and second implementations described above, and even in a general endoscope where the small-diameter channel portion 12e is not provided in the suction channel 12, it is possible to reduce blockage in the suction channel 12.

[0115] Furthermore, the present invention is not limited to the embodiments described above, and can be further modified and embodied by adapting the constituent elements during the implementation phase without departing from its spirit. Additionally, various inventive methods can be formed by appropriately combining the multiple constituent elements disclosed in the above embodiments. For example, several constituent elements may be deleted from all the constituent elements shown in the embodiments. Moreover, constituent elements from different embodiments may be appropriately combined. Thus, various modifications and applications can naturally be made without departing from the spirit of the invention.

[0116] This application is based on priority claims made in U.S. Provisional Application No. 63 / 155337, filed March 2, 2021, the disclosure of which is incorporated herein by reference in the specification, claims and drawings.

Claims

1. An endoscope, characterized in that, have: The insertion part inserted into the body of the examinee; and Attraction channel The attraction channel includes: The channel body inserted into the insertion part; and A small-diameter channel portion is disposed at the front end of the channel body, having an inner diameter smaller than the inner diameter of the channel body, and having a channel opening on the front end face of the insertion portion. The suction channel also serves as a treatment device channel. The suction channel simultaneously draws in broken stones and fluid from its opening. When the inner diameter of the main channel body is set to R1 and the inner diameter of the smaller channel section is set to R2, the attraction channel is configured to satisfy the following relationship: R1 / R2 > 1.27; The suction channel is configured to satisfy the following relationship with respect to the treatment device: R1-R3≥2(R2-R4) The treatment device comprises: a treatment device body that is inserted into the channel body and has an outer diameter R3; and a front end side shape portion that is inserted into the small diameter channel portion and has an outer diameter R4.

2. The endoscope according to claim 1, characterized in that, The attraction channel is configured to satisfy the following relationship: R1 / R2>1.

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3. The endoscope according to claim 1, characterized in that, The outer diameter of the front end shape of the treatment device is larger than the outer diameter of the main body of the treatment device, satisfying R4 > R3.

4. The endoscope according to claim 3, characterized in that, The treatment device is capable of moving axially along the insertion portion within the suction channel, with the main body of the treatment device inserted through the narrow-diameter channel portion.

5. The endoscope according to claim 1, characterized in that, The front end portion of the treatment device has the same outer diameter as the main body of the treatment device, satisfying R4=R3. The relation is expressed as follows: R1-R3≥2(R2-R3).

6. The endoscope according to claim 1, characterized in that, The suction channel is equipped with a suction tube connector, which connects to the suction tube that is connected to the suction pump.

7. An endoscope system comprising an endoscope and a stone fragmentation device, wherein, The endoscope has the following features: The insertion part inserted into the body of the patient; and Attraction channel The attraction channel includes: The channel body inserted into the insertion part; and A small-diameter channel portion is disposed at the front end of the channel body, having an inner diameter smaller than the inner diameter of the channel body, and having a channel opening on the front end face of the insertion portion. The suction channel simultaneously draws in broken stones and fluid from its opening. The stone crushing device includes: A probe, protruding from the insertion portion, breaks up the stone; and A generator that supplies energy to the probe; A pump that simultaneously draws in the liquid and the stones via the suction channel, or simultaneously recirculates the liquid and the stones; and The treatment device has a treatment device body inserted into the channel body and a front end side shape portion inserted into the narrow-diameter channel portion. When the inner diameter of the main channel body is set to R1 and the inner diameter of the smaller channel section is set to R2, the attraction channel is configured to satisfy the following relationship: R1 / R2 > 1.27; When the outer diameter of the main body of the treatment device is set to R3 and the outer diameter of the front end side shape portion is set to R4, the suction channel and the treatment device are configured to satisfy the following relationship: R1-R3≥2(R2-R4) The suction channel also serves as a treatment device channel. The treatment device is inserted into the suction channel and extends out of the channel opening to break up the stones. The pump simultaneously draws the stone and the liquid from between the narrow-diameter channel portion and the front-end side-shaped portion through the channel opening.

8. The endoscope system according to claim 7, characterized in that, The attraction channel is configured to satisfy the following relationship: R1 / R2>1.

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9. The endoscope system according to claim 7, characterized in that, The treatment device includes a laser probe that irradiates a laser to break up the stones.

10. The endoscope system according to claim 7, characterized in that, The endoscope system also has a fluid delivery channel that extends through the insertion portion and delivers fluid. The pump simultaneously draws in the liquid discharged from the liquid delivery channel into the subject body and the broken stones via the suction channel.

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