Endoscope device

Abstract

Disclosed is an endoscope apparatus. The endoscope apparatus of the present invention includes an endoscope having a flexible insertion portion inserted into a human body; a flexible channel attached to the insertion portion so that a portion forms a passage in a longitudinal direction of the insertion portion; and an auxiliary arm movably inserted into the passage and manipulated by a control device, the auxiliary arm including a forceps capable of gripping a human body tissue and a bending portion bent by the control device to pull the human body tissue gripped by the forceps.

Description

Technical Field

[0001] This invention relates to an endoscopic device, and more particularly to an endoscopic device configured to cut diseased tissue while directly observing the inside of internal organs or body cavities. Background Technology

[0002] In the early detection of gastrointestinal cancer, endoscopic resection using an endoscope equipped with a scalpel to remove the affected area is of great importance. Endoscopic resection includes endoscopic mucosal resection and endoscopic submucosal dissection.

[0003] Early-stage gastrointestinal cancers and polyps can develop into cancer and can be treated with endoscopic resection. Early diagnosis and treatment result in a high five-year survival rate, approaching 100%. The advantage of endoscopic resection is that it reduces the recovery period by minimizing the amount of skin on the patient's body rather than cutting into the skin, and by getting closer to the affected area than is a conventional surgical method.

[0004] However, since endoscopes are not medical diagnostic devices and therefore not surgical instruments, they suffer from limitations in function, leading to longer procedures and greater difficulty. In other words, existing commercial endoscopic surgeries face difficulties in tissue traction and visual field fixation. Therefore, for endoscopes, it is important to ensure a clear field of view of the cut portion by traction of the tissue being removed during resection.

[0005] However, the movement of surgical instruments in commercial endoscopes is limited to forward and backward movement, lacking independent bending operations and constrained by tissue traction. This increases the difficulty of resection and the risk of accidental bleeding and perforation when the field of view of the resected portion is difficult to stabilize.

[0006] Because of the growing need for traction to expose cut portions of tissue, various traction methods using additional attachments in commercial endoscopes are being investigated.

[0007] For example, there is a method of performing tissue traction using additional devices such as thin threads, clips, and magnets. However, the difficulty in adjusting the direction and force of traction, and the difficulty in readjusting the grip position, fundamentally limits the diversity and expansion of applicable surgical procedures.

[0008] Meanwhile, novel endoscopic surgical robot platforms with two remotely controlled robotic arms mounted on the endoscope's terminal have been developed; however, the long development and certification cycles and increased costs reduce economic viability, thus posing a high barrier to commercialization. Therefore, a method for mounting surgical auxiliary arms on a commercial endoscope is being investigated to secure the field of view for resection and to traction easily resectable tissue.

[0009] In this regard, Japanese Patent Application Publication No. 2005-131211 (hereinafter referred to as "Prior Document 1") discloses an external channel and an endoscope using the external channel.

[0010] The endoscope described in the existing literature is used by mounting an external channel onto the endoscope body. The external channel includes an external channel body having a length substantially the same as the endoscope body, a fixing part that can be mounted on the front end portion of the endoscope, and a locking part that can be mounted longitudinally on the endoscope.

[0011] The fixing part forms two openings (hereinafter referred to as "the first opening and the second opening") to form an approximate "8" shape. The front end portion of the external channel body is inserted into the first opening. The fixing part is secured to the external channel body by adhesive force and friction. The front end portion of the endoscope body is inserted into the second opening. The fixing part is made of an elastomer, such as rubber. The fixing part is connected to the front end portion of the endoscope body by adhesive force (tape bonding, etc.) and friction (mechanical / elastic locking, etc.).

[0012] The endoscope has a camera and lighting device at its tip for capturing images. The surgeon inserts the endoscope into the lumen through a natural opening such as the mouth or anus, and moves it to the target lesion while viewing the output image from the camera on a screen. The surgeon inserts a high-frequency surgical instrument into the channel of the endoscope body and inserts an auxiliary robotic arm into the outer channel body. The surgeon removes the lesion while using the auxiliary robotic arm to lift the lesion removed by the high-frequency surgical instrument.

[0013] However, a problem with existing endoscopes is that the robotic arm inserted into the external channel can only move back and forth in the longitudinal direction of the external channel, thus limiting its movement. Therefore, existing endoscopes cannot hold tissue and pull the held tissue in the desired direction, which is a decisive reason for limiting endoscopic surgery, especially increasing the difficulty of endoscopic resection.

[0014] Furthermore, in existing literature on endoscopes, in order to use an auxiliary robotic arm to grasp and pull tissues, the endoscope itself needs to be moved, which presents a visual problem of difficulty in fixing the camera image.

[0015] Furthermore, a problem with existing endoscopes is that, because the front end of the external channel body protrudes further than the fixed part, the front end of the external channel body is prone to damaging the inner wall when moving the endoscope to the target lesion.

[0016] In existing literature, endoscopic surgery is typically performed by both the operating surgeon and an assistant surgeon. The operating surgeon removes the target lesion by manipulating the flexible endoscope's forward and backward movement and bending. Specifically, the operating surgeon uses one hand to operate the flexible endoscope and the other hand to operate its insertion point. Furthermore, the assistant surgeon, acting on instructions from the operating surgeon, controls the on / off operation of high-frequency surgical instruments and manipulates the assistive robotic arm. That is, the assistant surgeon uses one hand to operate the high-frequency surgical instrument control mechanism and the other hand to operate the assistive robotic arm control mechanism.

[0017] Typically, an assistive robotic arm assembly consists of an assistive robotic arm, a flexible tube, and a control unit. The flexible tube is formed into a long tube. The control unit is connected to one of the flexible tubes, and the assistive robotic arm is connected to the other. Multiple tendons are provided within the flexible tube. The tendons connect the assistive robotic arm and the control unit. When the control unit is manipulated, the tension of the tendons changes, thereby assisting the robotic arm in its operation.

[0018] Flexible tubes are easily deformed by external forces. However, when the shape of the flexible tube is deformed, the tension of the tendon changes, so the shape of the flexible tube should be kept as constant as possible during endoscopic surgery. However, the problem is that because the assistant surgeon uses one hand to operate the high-frequency surgical instruments and the other hand to operate the auxiliary robotic arm control device, it is difficult to maintain the shape of the flexible tube consistently during endoscopic surgery.

[0019] Existing technical documents

[0020] Patent documents

[0021] (Patent Document 1) Japanese Patent Application Publication No. 2005-131211 (Publication Date: May 26, 2005) Summary of the Invention

[0022] Technical issues

[0023] The purpose of this invention is to provide an endoscope device that can adjust the traction direction and gripping position of the auxiliary arm.

[0024] Furthermore, the present invention aims to provide an endoscope device that can prevent damage to the body cavity wall during the movement of the endoscope device to the target lesion in the body cavity.

[0025] In addition, the present invention aims to provide an endoscope device that can prevent deformation of the flexible tube even when a physical assistant operates different devices with both hands.

[0026] Technical solution

[0027] This objective is achieved by an endoscopic device comprising: an endoscope having a flexible insertion portion that is inserted into a human body; a flexible channel attached to the insertion portion such that a portion forms a passage along the longitudinal direction of the insertion portion; and an auxiliary arm movably inserted into the passage and manipulated by a control device, the auxiliary arm comprising forceps capable of gripping human tissue and a curved portion that is bent by the control device to pull the human tissue gripped by the forceps.

[0028] The bend can form a flexible joint structure.

[0029] The bending portion may include multiple links and multiple tendons, with the tendons sequentially connected to the forceps and penetrating the links.

[0030] The auxiliary arm can be rotatably inserted into the passage so that it can be driven in multiple degrees of freedom.

[0031] Endoscopic devices may include a cap that connects the front end portion of a flexible channel to the front end portion of an insertion site.

[0032] In this cover, a first insertion hole and a second insertion hole can be formed, with the front end of the insertion part inserted into the first insertion hole and the front end of the flexible channel inserted into the second insertion hole.

[0033] The bearing or bushing may be located between the outer surface of the front end portion of the flexible channel and the inner surface of the second insertion hole.

[0034] The front surface of the cap may be tilted backward toward the second insertion hole based on the center of the first insertion hole.

[0035] The auxiliary arm may include a flexible tube connecting the bend and the control device, and may be configured to include a body attachment type fixation device that enables the operation of multiple surgical instruments with both hands and maintains the linear form of the flexible channel at the portion of the flexible tube inserted into the access, or the fixation device or retainer may be attached to the patient's bend or tray, or attached to an endoscopic instrument.

[0036] The retainer may include a base forming a linear mounting groove into which the flexible channel is inserted, and a body formed above the base and grasped by a user to adjust the position and orientation of the mounting groove.

[0037] The bearing or bushing can be located between the outer surface of the flexible channel and the inner surface of the mounting groove.

[0038] The main body can be symmetrically formed based on the reference surface to be grasped by either of the two hands, and the mounting slot can include a first mounting slot and a second mounting slot. The first mounting slot has an angle between it and the reference surface, and the second mounting slot has a symmetrical form based on the reference surface and the first mounting slot.

[0039] The retainer may include: a base, a flexible channel detachably coupled to the base in a linear form; and a body formed above the base and gripped by a user with at least one of the index and ring fingers and the palm with the thumb, index, and middle fingers.

[0040] The retainer may include an extension that extends upward from the body so that it can be wrapped between the thumb and index finger by the user.

[0041] The retainer may include a locking portion extending from the body, and when the clamping force on the body is released, the retainer may be suspended on the index or ring finger holding the body via the locking portion.

[0042] The cap can be made of a flexible material that can flatten upon contact with mucus within the organ, and the cap can be reverted to its original form by the assistive arm as it moves forward through the passage.

[0043] Tweezers can be formed into widened and folded plyer forms, and one of the plyer forms can be longer than the other, so that the tweezers can hold the tissue flat.

[0044] The curved section can be attached to the forceps, and the forceps and the curved section can be non-parallel at their joints so that the forceps can keep the tissue flat.

[0045] Beneficial effects

[0046] According to the present invention, an endoscope device is provided, which is configured to adjust the direction of movement and clamping position of the auxiliary arm while the endoscope stops when the bending portion is bent by a control device, thereby pulling the body tissue held by the forceps.

[0047] In addition, an endoscope device is provided, which is configured to drive the auxiliary arm with multiple degrees of freedom when the auxiliary arm forms a flexible joint structure to achieve free movement in the front-back, up-down, and left-right directions, thereby effectively performing fixation of the field of view and movement of tissue traction during tissue cutting.

[0048] Alternatively, an endoscope device may be provided, which is configured such that, during the insertion of the endoscope into the target lesion, the front surface of the cap tilts backward toward the second insertion hole with the center of the first insertion hole as the center, thereby preventing the formation of wounds in the lumen.

[0049] Alternatively, an endoscope device can be provided that is configured to prevent deformation of the flexible tube while the assistant physician holds both the endoscopic surgical tools and the control device with both hands, and while a retainer maintains the linear form of the flexible channel in the portion into which the flexible tube is inserted, the device also prevents deformation of the flexible tube. Attached Figure Description

[0050] Figure 1 This is a perspective view illustrating an endoscopic device according to a first exemplary embodiment of the present invention.

[0051] Figure 2 yes Figure 1 Diagram showing the usage status of endoscopic equipment.

[0052] Figure 3 It means Figure 1 A magnified view of the insertion part, flexible channel, and cap of the endoscope device 10.

[0053] Figure 4a yes Figure 3 An exploded perspective view of the insertion part, flexible channel, and cap.

[0054] Figure 4b It shows Figure 1 Partial exploded perspective view of the insertion unit, flexible channel, bearing and cap of the endoscope device.

[0055] Figure 5 yes Figure 3 A plan view of the insertion part, flexible channel, and cap.

[0056] Figure 6 yes Figure 3 Side view of the hat.

[0057] Figure 7 and Figure 8 It means to use Figure 1 A diagram illustrating the removal of diseased areas by endoscopic polypectomy using endoscopic equipment.

[0058] Figure 9 This is a perspective view illustrating an endoscopic device according to a second exemplary embodiment of the present invention.

[0059] Figure 10 It is shown Figure 9 A partial perspective view of the control device, retainer, surgical unit, and handle in their usage condition.

[0060] Figure 11 It means Figure 9 A perspective view of the retainer of the endoscopic device.

[0061] Figure 12 It is shown Figure 11A bottom view of the mounting slot for the retainer.

[0062] Figure 13a yes Figure 11 The diagram shows the mounting slot of the fixture.

[0063] Figure 13b This shows the bearing is installed. Figure 11 A schematic diagram showing the state of the mounting slot.

[0064] Figure 14 This is a schematic diagram showing a body attachment type fixation device.

[0065] Figure 15 This is a schematic diagram showing a fixation device that is attached to a patient's bed or surgical tray.

[0066] Figure 16 This is a schematic diagram showing a commercial tool attachment type fixing device.

[0067] Figure 17 This is a side view showing the deformed state of the hat.

[0068] Figure 18 This is a side view showing the state where the hat has returned to its original shape.

[0069] Figure 19 This is a side view showing the auxiliary arm pulled out in front of the cap.

[0070] Figures 20 to 22 It shows the use of Figure 1 A diagram illustrating the removal of diseased areas by endoscopic polypectomy using endoscopic equipment. Detailed Implementation

[0071] The preferred embodiments of the present invention will now be described in detail with reference to the accompanying drawings. However, in order to make the spirit of the invention clearer, descriptions of well-known functions or configurations will be omitted.

[0072] The endoscopic device of the present invention is configured to adjust the traction direction and gripping position of the auxiliary arm.

[0073] Furthermore, the endoscopic device of the present invention is configured to prevent damage to the body cavity wall during the movement to the target lesion in the body cavity.

[0074] Furthermore, the endoscopic device of the present invention is configured to allow the auxiliary arm to move easily forward and backward even when multiple bends and rotations are formed within the body cavity.

[0075] Furthermore, the endoscopic device of the present invention can prevent deformation of the flexible tube even when different devices are operated by a physical assistant with both hands.

[0076] First exemplary embodiment

[0077] Figure 1 This is a perspective view showing an endoscope device 10 according to a first exemplary embodiment of the present invention. Figure 2 yes Figure 1 A schematic diagram of the usage status of the endoscope device 10.

[0078] The endoscopic device 10 according to a first exemplary embodiment of the present invention can be widely used for endoscopic polypectomy. In particular, the endoscopic device 10 can be effectively used for endoscopic polypectomy of early gastrointestinal cancers (esophagus, stomach, large intestine).

[0079] like Figure 1 and Figure 2 As shown, the endoscopic device 10 according to a first exemplary embodiment of the present invention includes an endoscope 100, a flexible channel 200, a cap 300, an auxiliary arm module 400, and a surgical unit 500.

[0080] Endoscope 100 can be supplied as a commercial endoscope. Endoscope 100 includes an insertion section 110 and a manipulation unit 120. (As...) Figure 1 As shown, during the endoscopic polypectomy, a gastroenterologist 1 (hereinafter referred to as the "surgical surgeon") manipulates the insertion section 110 and the manipulation unit 120.

[0081] The insertion part 110 is the part that enters the body from inside the mouth of the patient 3. During the endoscopic polyp removal surgery, the surgeon 1 holds one side of the insertion part 110 and inserts the insertion part 110 into the mouth of the patient 3. The surgeon 1 confirms through the monitor 700 in the operating room whether the endoscope 100 has moved to the diseased area 4.

[0082] The length of the insertion part 110 can be approximately 1 to 5 m. The thickness of the insertion part 110 can be approximately 9.5 mm. The insertion part 110 can be inserted into the inner cavity and flexibly bends according to the curvature of the inner cavity.

[0083] Multiple cables and tubes are disposed inside the insertion part 110. Channel 114 forms a passage through which the conduit 520 of the electrosurgical unit 500 moves. The cables generate tension that causes the bends of the terminals of the insertion part 110 to bend.

[0084] An objective lens 111, a light source lens 112, a nozzle 113, and the front end of a channel 114 are provided at the front end of the insertion part 110.

[0085] The end of the insertion section 110 refers to the end portion opposite to the operating unit 120. Light from the endoscope 100's light source is transmitted via optical fiber to the light source lens 112 at the end of the endoscope 100. Light incident on the objective lens 111 is output to the monitor 700 in the operating room via optical fiber and an imaging device. The nozzle 113 sprays liquid to clean the objective lens 111.

[0086] Multiple knobs 121 and fixing devices 122 are provided in the operating unit 120. A gastroenterologist can bend the bent portion of the terminal of the insertion part 110 by operating the knobs 121. A gastroenterologist can stop the movement of the knobs 121 by operating the fixing devices 122.

[0087] like Figure 1 and Figure 2 As shown, the flexible channel 200 is formed in the form of a long tube. The flexible channel 200 forms a cylindrical passage 201 through which the auxiliary arm 410 moves. The flexible channel 200 can be made of an elastically deformable material, such as medical rubber or medical silicone. The portion of the flexible channel 200 through which the tool is inserted can also be made of a rigid material.

[0088] A portion of the flexible channel 200 is attached to the insertion portion 110 to form a passage 201 in the longitudinal direction of the insertion portion 110. One end (front end portion) of the flexible channel 200 is connected to the end portion (front end portion of the insertion portion 110) via a cap 300. A bearing or bushing may be disposed between the flexible channel 200 and the cap 300 so that the flexible channel 200 rotates instead of twisting during endoscopic polypectomy.

[0089] The flexible channel 200 is attached to the insertion portion 110 from the end of the insertion portion 110 in the longitudinal direction of the insertion portion 110 by a "predetermined length". The "predetermined length" refers to a length longer than the length of the insertion portion 110 inserted into the inner cavity.

[0090] The flexible channel 200 is attached to the insertion portion 110 within a "predetermined length" by a plurality of mounting members 210. The mounting members 210 may be tape. When the insertion portion 110 is inserted into the cavity and bends due to the curvature of the cavity, the flexible channel 200 is bent together with the insertion portion 110 by the mounting members 210.

[0091] The flexible channel 200 can be movably attached to the insertion portion 110 via the mounting member 210. The tape can form an adhesive force with the flexible channel but not with the insertion portion 110.

[0092] Therefore, during the period when the insertion portion 110 bends due to the bending of the inner cavity, the flexible channel 200 can move slightly to a position that minimizes the bending resistance of the insertion portion 110.

[0093] Therefore, even if the insertion portion 110 bends due to the curvature of the inner cavity, the resistance of the flexible channel 200 to the bending of the insertion portion 110 is minimized. Furthermore, even if the curved portion at the end of the insertion portion 110 bends backward, the resistance of the flexible channel 200 to the bending of the curved portion is reduced.

[0094] Figure 3 It shows Figure 1 A partial enlarged view of the insertion part 110, the flexible channel 200, and the cap 300 of the endoscope device 10.

[0095] Figure 4a yes Figure 3 Exploded perspective view of the insertion part 110, the flexible channel 200 and the cap 300. Figure 5 yes Figure 3 A plan view of the insertion part 110, the flexible channel 200, and the cap 300. Figure 6 yes Figure 3 Side view of the cap 300.

[0096] like Figure 3 and Figure 4a As shown, the cap 300 connects the front end portion of the flexible channel 200 to the front end portion of the insertion portion 110. A first insertion hole 301 and a second insertion hole 302 are formed in the cap 300.

[0097] The front end of the insertion part 110 is inserted into the first insertion hole 301. The diameter of the first insertion hole 301 is smaller than the diameter of the front end of the insertion part 110. The cap 300 can be made of an elastically deformable material, such as medical rubber or medical silicone.

[0098] Therefore, the inner surface of the insertion portion 110 is in close contact with the outer surface of the front end portion of the insertion hole 110. The cap 300 can be fixed to the outer surface of the front end portion of the insertion portion 110 by its own elastic restoring force. In order to strengthen the bonding force between the cap 300 and the insertion portion 110, adhesive tape can be pasted along the boundary of the cap 300, the insertion portion 110 and the flexible channel 200.

[0099] The front end of the flexible channel 200 is inserted into the second insertion hole 302. The diameter of the second insertion hole 302 is smaller than the diameter of the front end of the flexible channel 200. The cap 300 may be made of an elastically deformable material, such as medical silicone.

[0100] Therefore, the inner surface of the second insertion hole 302 is in close contact with the outer surface of the front end portion of the flexible channel 200. The cap 300 can be fixed to the outer surface of the front end portion of the insertion part 110 by its own elastic restoring force. In order to strengthen the bonding force between the cap 300 and the flexible channel 200, tape can be pasted along the boundary between the cap 300 and the insertion part 110 and the flexible channel 200.

[0101] Figure 4b It shows Figure 1 Partial exploded perspective view of the insertion part 110, flexible channel 200, bearing 305 and cap 300 of the endoscope device.

[0102] like Figure 4b As shown, a bearing 305 (or bushing) can be positioned between the flexible channel 200 and the cap 300. The bearing 305 can be connected to the rear end portion of the second insertion hole 302. The outer surface of the front end portion of the flexible channel 200 can be connected to the inner surface of the bearing 305. Therefore, during endoscopic polypectomy, the front end of the flexible channel 200 can rotate freely within the second insertion hole 302. Thus, during endoscopic polypectomy, the flexible channel 200 can rotate based on the cap 300 without being twisted.

[0103] The cap 300 is made of a transparent material to prevent light incident on the objective lens 111 from being blocked. The front surface 303 of the cap 300 protrudes in front of the front end portion of the insertion part 110. Therefore, when the staining solution is injected into the diseased area 4 before being cut by the needle, the front surface 303 of the cap 300 can press against the circumference of the diseased area 4 along the first insertion hole 301.

[0104] like Figure 6 As shown, the front surface 303 of the cap 300 is formed to be inclined rearward toward the second insertion hole 302 at a predetermined angle α based on the center of the first insertion hole 301. Therefore, during the movement of the endoscope device 10 to the target lesion in the lumen, the generation of friction between the front surface 303 of the cap 303 and the lumen wall is reduced, thereby preventing damage to the lumen.

[0105] like Figure 2 As shown, the auxiliary arm module 400 includes an auxiliary arm 410 and a control device 420.

[0106] The control device 420 is the component that manipulates the auxiliary arm 410. A trigger 421 and a wheel 422 (or lever) are formed within the control device 420. The assistant physician 2 operates the control device 420 according to the instructions of the surgical surgeon 1.

[0107] The auxiliary arm 410 is movably inserted into the passage 201 and includes tweezers 411, a bend 412, and a flexible tube 413.

[0108] Tweezers 411 are components used to hold biological tissue. Tweezers 411 are formed into a widened and folded clamp shape. Trigger 421 and tweezers 411 are connected by one or more wires (not shown). When the assistant physician 2 manipulates trigger 421, the tweezers 411 widens and wrinkles as the wires are pulled.

[0109] As disclosed in Korean Patent Application No. 2017-0078616 (which has not been examined), its detailed description will be omitted since the operating structure of the thread and tweezers 411 is known technology.

[0110] In addition to tweezers, the auxiliary arm 410 can also consist of a suction tube, a needle, a knife, and a coagulation gripper.

[0111] The bend 412 is connected to the tweezers 411. The bend 412 forms a flexible joint structure. The bend 412 includes multiple connecting rods 412A and multiple tendons 412B.

[0112] Linkage 421A is arranged sequentially starting from tweezers 411. The two ends of tendon 412B are connected to tweezers 411 and wheel 422. Tendon 412B passes sequentially through link 412A. When wheel 422 of control device 420 rotates, tendon 412B is selectively pulled or released, and bending portion 412 bends.

[0113] As disclosed in Korean Patent Registration No. 2349030, since the operating structure of tendon 412B and bending portion 412 is known technology, its detailed description will be omitted.

[0114] The auxiliary arm 410 is rotatably inserted into the passage 201. Therefore, when the assistant physician 2 rotates the control device 420 by turning his wrist, the auxiliary arm 410 rotates about the longitudinal direction of the passage 201. Thus, when the assistant physician 2 changes the rotation angle of the control device 420, the auxiliary arm 410 can be driven with multiple degrees of freedom.

[0115] The flexible tube 413 connects the bend 412 and the control device 420. The flexible tube 413 forms a passage for receiving wires and tendons 412B between the bend 412 and the control device 420.

[0116] The flexible tube 413 can be made of an elastically deformable material, such as medical rubber or medical silicone. When the insertion part 110 is inserted into the inner cavity and bends due to the bending of the inner cavity, the flexible tube 413 bends together with the flexible channel 200 in the flexible channel 200.

[0117] like Figure 2 As shown, the surgical unit 500 includes a handle 510, a catheter 520, and a wire 530. Although not shown, an electrosurgical unit for supplying current to the wire 530 is also provided.

[0118] The conduit 520 is elongated in one direction. The conduit 520 has a hollow channel. The conduit 520 is made of a flexible material. A wire 530 is inserted into this hollow channel.

[0119] Handle 510 is a component that controls line 530. The assistant physician 2 operates handle 510 according to the instructions of the surgeon 1 to control the insertion or withdrawal of line 530 in the longitudinal direction of catheter 520.

[0120] As disclosed in Korean Patent Application No. 2022-0028878 (which has not been examined), its detailed description will be omitted since the surgical unit 500 is known technology.

[0121] Figure 7 and Figure 8 It means to use Figure 1 A schematic diagram of the diseased area 4 removed by the endoscopic device 10 through endoscopic polypectomy.

[0122] While observing the monitor 700, the surgeon 1 moves the insertion part 110 to the affected area 4, whereby the assistant physician 2 injects the staining solution into the affected area 4 by inserting a needle into the channel 114 of the endoscope 100.

[0123] Then, the assistant physician 2 inserts the catheter 520 of the surgical unit 500 into the channel 114 of the endoscope 100. In addition, the assistant physician 2 inserts the auxiliary arm 410 into the passage 201 of the flexible channel 200 so that the forceps 411 and the bend 412 protrude toward the diseased area 4.

[0124] Then, the surgeon 1 observes the affected area 4 through the monitor 700 while operating the insertion part 110, the manipulation unit 120, and the catheter 520 to cut open the affected area 4. During this process, the assistant surgeon 2 operates the handle 510 according to the instructions of the surgeon 1 to input and output the wire 530 at the end of the catheter 520.

[0125] In addition, the assistant doctor 2 manipulates the control device 420 to grasp the diseased area 4 with tweezers 411 and bends the curved part to pull the diseased area 4, thereby easily cutting open the diseased area 4.

[0126] In this configuration, the auxiliary arm 410 moves independently of the camera of the endoscope 100 to effectively perform traction movements of the tissue while fixing the field of view of the affected area 4. Furthermore, the auxiliary arm 410 is controlled intuitively by using the control device 420.

[0127] Gastric ESD was performed on live pigs to verify the effectiveness of the endoscopic device (IRB: NOTUS IACUC 20-KE-233,264) according to a first exemplary embodiment of the present invention. The stomach was divided into 8 sections. Using a commercial endoscope (GIFQ260J from Olympus, Japan), ESD was performed to the lesions in various parts of the stomach, both with and without the assistance of the auxiliary arm 410.

[0128] ESD is performed in the following sequence: marking, injection, pre-cutting, peeling, and sample removal. Marking is done with a diameter of 30 mm. During peeling, the auxiliary arm 410 performs the task of elevating the mucosal tissue. The endoscopic procedure is performed by an experienced clinician who has performed 800 or more ESDs. The auxiliary arm 410 is controlled by an experienced engineer.

[0129] Effectiveness was evaluated by measuring total operation time (sec), pre-cutting time (sec), peeling speed (mm² / sec), and number of perforations. Peeling speed was calculated by dividing the sample area by the time required for peeling.

[0130] It was confirmed that the auxiliary arm 410 bends well in various endoscopic positions, including the retracted position. It was also confirmed that the auxiliary arm 410 can perform tissue traction in all directions. During the experiment, the auxiliary arm 450 demonstrated sufficient force to lift the tissue and apply tension to the desired level. No damage to the stomach or esophagus was observed due to the connection of the auxiliary arm 410.

[0131] The results for total operation time, pre-cutting time, dissection speed, and number of perforations are shown in Table 1 below.

[0132] Table 1

[0133]

[0134] It can be confirmed that the assisted ESD procedure time is shortened compared to traditional ESD. The incision time is slightly longer than that of previous ESD procedures, but the difference is not significant. It was determined that the dissection speed is 1.5 times faster when using the assisted arm 410. It can be confirmed that a perforation occurred in the case of traditional ESD, but no perforation occurred when using the assisted arm 410.

[0135] Second exemplary embodiment

[0136] Figure 9 This is a perspective view showing an endoscope device 20 according to a second exemplary embodiment of the present invention. Figure 10 It is shown Figure 9 A partial perspective view of the control device 420, retainer 600, surgical unit 500, and handle 510 in their usage state.

[0137] like Figure 9 As shown, the endoscopic device 20 according to a second exemplary embodiment of the present invention includes an endoscope 100, a flexible channel 200, a cap 300, an auxiliary arm module 400, a surgical unit 500, and a retainer 600.

[0138] The endoscope 100, flexible channel 200, cap 300, auxiliary arm module 400, and surgical unit 500 of the endoscope device 20 according to the second exemplary embodiment of the present invention are substantially the same as those in the first exemplary embodiment of the present invention. Therefore, in the following description, for ease of understanding of the endoscope device 20 according to the second exemplary embodiment of the present invention, the retainer 600 will be described in detail.

[0139] like Figure 9 and Figure 10 As shown, the retainer 600 is a component that allows for the operation of multiple surgical instruments with both hands and maintains the linear form of the flexible channel 200 at the portion of the flexible tube 413 inserted into the passage 201. The retainer 600 includes a base 610, a body 620, an extension 630, and a locking portion 640.

[0140] Figure 11 It means Figure 9 Perspective view of the retainer 600 of the endoscopic device 20.

[0141] like Figure 11 As shown, the base 610 is the component that forms the mounting groove 611. The mounting groove 611 is composed of a linear groove into which the flexible channel 200 is inserted. The flexible channel 200 is separated from and connected to the mounting groove 611 in a linear manner.

[0142] The base 610 is disposed at the bottom of the retainer 600. The bottom of the retainer 600 forms a flat surface. Therefore, the retainer 600 can be mounted on top of the surgical cart.

[0143] like Figure 10 As shown, the main body 620 is the component that the user, i.e., the assistant doctor 2, holds with one hand. The main body 620 is formed above the base 610. The main body 620 has a form that extends upward from the base 610. The assistant doctor 2 holds the main body 620 to adjust the position and orientation of the mounting slot 611.

[0144] A flexible tube 413 is formed between the bending unit 412 and the control device 420 as a channel for receiving the suture and tendon 412B. The bending of the flexible tube 413 affects the tension of the suture and tendon 412B. Therefore, maintaining the shape of the flexible tube 413 is important during endoscopic polypectomy.

[0145] like Figure 9 and Figure 10As shown, in order to minimize tension fluctuations in the line and tendon 412B caused by the bending of the flexible tube 413 during endoscopic polypectomy, the flexible tube 413 should be kept as linear as possible.

[0146] Reference Figure 1 In the first exemplary embodiment of the present invention, the assistant physician 2 shall hold the flexible channel 200 by using the index and ring fingers of the hand holding the surgical unit handle 510 to maintain the linear form of the flexible channel 200 at the portion of the flexible tube 413 inserted into the passage 201.

[0147] However, because the area of ​​the flexible channel 200 in contact with the index and ring fingers is small, and the flexible channel 200 is easy to rotate or bend between the index and ring fingers, it is not easy to maintain the linear form of the flexible channel with the index and ring fingers of the hand manipulating the surgical unit handle 510.

[0148] like Figure 10 As shown, in the second exemplary embodiment of the present invention, the assistant doctor 2 holds the main body 620 and adjusts the position and orientation of the mounting groove 611 to maintain the linear form of the flexible channel 200 in the portion where the flexible tube 413 is inserted into the passage 201.

[0149] Figure 12 It is shown Figure 11 Bottom view of the mounting slot 611 of the retainer 600.

[0150] like Figure 12 As shown, the main body 620 is formed in a symmetrical shape based on the reference surface (RF). Therefore, even if the assistant doctor 2 holds the main body 620 with either of his hands, the reference surface (RF) forms a substantially identical spacing angle with the front surface of the assistant doctor 2.

[0151] like Figure 11 As shown, grooves corresponding to the grasping forms of the index and ring fingers are formed in the main body 620. The assistant doctor 2 can grasp the main body 620 using at least one of the index and ring fingers, as well as the palm of the hand.

[0152] like Figure 10 As shown, the assistant doctor 2 can grasp the main body 620 using the thumb, index finger, and middle finger. Therefore, the assistant doctor 2 can easily manipulate the surgical unit handle 510 using the thumb, index finger, and middle finger of the hand grasping the main body 620.

[0153] like Figure 12 As shown, the mounting slot 611 includes a first mounting slot 612 and a second mounting slot 613.

[0154] The first mounting groove 612 forms a predetermined angle θ with the reference surface (RF). The second mounting groove 613 is symmetrical to the first mounting groove 612 based on the reference surface (RF). Therefore, the second mounting groove 613 also forms an angle θ with the reference surface (RF).

[0155] The predetermined angle θ is derived through biotechnology design. When the user can conveniently grip the main body 620 and the control device 420 with both hands, the first mounting slot 612 or the second mounting slot 613 can be located on the same line as the front of the control device 420. As an example, θ can be 35°.

[0156] The diameters of the first mounting groove 612 and the second mounting groove 613 are equal to or smaller than the diameter of the flexible channel 200. The flexible channel 200 can have a bonding force to the mounting groove 611 through its own elastic force.

[0157] Figure 13a yes Figure 11 A schematic diagram of the mounting slot 611 of the retainer 600.

[0158] like Figure 13a As shown, the flexible channel 200 is inserted into the first mounting groove 612 and the second mounting groove 613 through an inlet groove 614 that is narrower than the first mounting groove 612 and the second mounting groove 613. The narrow gap of the inlet groove 614 suppresses unintended deviation of the flexible channel 200.

[0159] Figure 13b This shows that bearing 615 is installed... Figure 11 A schematic diagram of the state in the mounting slot 611.

[0160] like Figure 13b As shown, a bearing 615 (or bushing) can be inserted between the inner surfaces of the flexible channel 200 and the mounting groove 611. The bearing 615 can be attached to the inner surface of the mounting groove 611. The outer surface of the flexible channel 200 can be attached to the inner surface of the bearing 615. Therefore, during endoscopic polypectomy, the flexible channel 200 can rotate freely within the mounting groove 611. Thus, during endoscopic polypectomy, the flexible channel 200 can rotate based on the mounting groove 611 without being twisted.

[0161] like Figure 10 and Figure 11 As shown, the extension 630 extends upward from the main body 620. The assistant doctor 2 can wrap the extension 630 around the part between the thumb and index finger of his hand. Therefore, even though the main body 620 is grasped only by at least one of the index and ring fingers and the palm, the assistant doctor 2 can still inhibit the movement of the main body 620.

[0162] The locking part 640 extends from the top of the body 620. The locking part 640 has the form of the top of at least one of the index finger and ring finger that wrap around and grasp the body 620.

[0163] Even if the gripping force on the main body 620 is released, the retainer 600 is suspended on the index or ring finger holding the main body 620 by the locking part 640. Therefore, even if the gripping force on the main body 620 is released due to the assistant physician 2's error or external force, the retainer 600 can be prevented from falling off and any medical accidents caused thereby.

[0164] Third Exemplary Example

[0165] Figure 14 This is a schematic diagram showing a body attachment type fixation device 700. Figure 15 The figure shows a fixation device 800 that is fixed to a patient's bed or surgical tray. Figure 16 This is a schematic diagram showing a commercial tool attachment type fixing device 900.

[0166] like Figures 14 to 16 As shown, retainer 600 can be replaced by body attachment type fixation device 700, (other) fixation device 800, or commercial tool attachment type fixation device 900 that are attached to the patient's bed, tray, or endoscopic tool.

[0167] like Figure 14 As shown, the body attachment type fixation device 700 can refer to a device that can be fixed to the wrist of the assistant physician 2 or a device that can be attached to the body of the patient 3. The body attachment type fixation device 700 may include an attachment base 710 and an attachment member 720 (hereinafter referred to as the "first attachment member"). The attachment base 710 may have a similar or identical structure to the base 610 of the second exemplary embodiment.

[0168] The first attachment member 720 is connected to the attachment base 710. The first attachment member 720 is composed of various components that can be attached / fixed to the wrist of the assistant physician 2 or the body of the patient 3. The various components can refer to components that can be detached from the wrist or body, such as Velcro tape, etc.

[0169] like Figure 15 As shown, another fixation device 800 may refer to a movable tray-type temporary retainer or a device that can be attached to a surgical / operating table. Another fixation device 800 may also be attached to the handle portion of a commercial tool. Another fixation device 800 may include an attachment base 810 and an attachment member 820 (hereinafter referred to as the "second attachment member"). The attachment base 810 may have a similar or identical structure to the base 610 of the second exemplary embodiment.

[0170] The second attachment member 820 is connected to the attachment base 810. The second attachment member 820 is composed of a movable tray-type temporary retainer or various components that can be mounted on the operating table. Various components may refer to movable tray-type temporary retainers or components that can be detached from the operating table, such as clamps, forceps, Velcro, etc.

[0171] like Figure 15 As shown, the commercial tool attachment type fastener 900 can represent a device for attaching a commercial tool to a letter. The commercial tool attachment type fastener 900 may include an attachment base 910 and an attachment member 920 (hereinafter referred to as the "third attachment member"). The attachment base 910 may have a similar or identical structure to the base 610 of the second exemplary embodiment.

[0172] The third attachment member 920 is attached to the attachment base 910. The third attachment member 920 is formed above the attachment base 910. The third attachment member 920 is a component that the assistant physician 2 holds with one hand. The third attachment member 920 may have a similar or identical structure to the body 620 of the second exemplary embodiment.

[0173] The third attachment member 920 is formed in the form of extending upward from the attachment base 910. The third attachment member 920 can be attached to a commercial tool. Here, the commercial tool can refer to the electrosurgical unit 500A. In this case, the third attachment member 920 can be attached to the handle 510A of the electrosurgical unit 500A. As an example, a groove into which the handle 510A is inserted can be formed on the top of the third attachment member 920. The assistant physician 2 manipulates the handle 510A while grasping the body 620 to control the insertion or withdrawal of the line 530 in the longitudinal direction of the catheter 520A.

[0174] Figure 17 This is a side view showing the deformed state of the cap 300. Figure 18 This is a side view showing the shape recovery state of the cap 300. Figure 19 This is a side view showing the state in which the auxiliary arm 410 is pulled out to the front of the cap 300.

[0175] like Figure 17 As shown, the cap 300 can be made of a flexible material that can be flat when in contact with the mucous membrane inside the organ. As an example, the cap 300 can be made of an elastically deformable material, such as medical rubber, medical silicone, etc. Figure 17 The arrows indicate the forces exerted by the organ's mucosa on the cap 300. The cap 300 is flat when in contact with the organ's mucosa to minimize mucosal scraping, which can occur when large-diameter endoscopic instruments are inserted into the esophagus and large intestine.

[0176] like Figure 18 and Figure 19 As shown, when the auxiliary arm 410 moves forward in the passage, the shape of the cap 300 can be restored to its original shape by the auxiliary arm 410. When the auxiliary arm 410 moves forward, the interior of the channel 200 and the cap 300 can be applied and coated with lubricant, so that the flexible channel 200 and the cap 300 are restored to their initial state, and the auxiliary arm 410 moves forward smoothly.

[0177] Figures 20 to 22 It means to use Figure 1 A schematic diagram of the diseased area 4 removed by the endoscopic device 10 through endoscopic polypectomy.

[0178] like Figure 20 As shown, the forceps 411 are formed into a widened and folded clamp shape. However, when the mucosal tissue of the diseased area 4 is placed horizontally, the forceps 411 sometimes have difficulty holding the mucosal tissue.

[0179] like Figure 21 As shown, the forceps 411 and the curved portion 412 may not be parallel at the point where they connect to each other, so that the forceps 411 can easily hold the tissue flat. Therefore, during the bending of the curved portion 412 toward the diseased area, the forceps 411 may also be opposite to the mucosal tissue of the diseased area 4. Therefore, when the mucosal tissue of the diseased area 4 is placed horizontally, the forceps 411 may sometimes have difficulty holding the mucosal tissue.

[0180] like Figure 22 As shown, either side of the clamp-like shape can be formed to be longer than the other side so that the forceps 411 can easily hold flat tissue. That is, when the lower jaw of the forceps 411 is longer than the upper jaw, it is easier to grasp flat tissue.

[0181] According to the present invention, an endoscope device 10 is provided, which is configured to adjust the travel direction and clamping position of the auxiliary arm 410 while the endoscope 100 stops when the bending portion 412 is bent by the control device 420, thereby pulling the body tissue held by the forceps 411.

[0182] In addition, an endoscope device 10 can be provided, wherein the auxiliary arm 410 forms a flexible joint structure to enable free movement in the front-back, up-down and left-right directions. The endoscope device 10 is configured to effectively perform traction movements of tissue during field fixation and tissue cutting by enabling the auxiliary arm 410 to be driven in multiple degrees of freedom.

[0183] In addition, an endoscope device 10 may be provided, which is configured to prevent trauma to the lumen when the front surface of the cap 300 tilts backward toward the second insertion hole 302 around the center of the first insertion hole 301 during the insertion of the endoscope 100 into the target lesion.

[0184] In addition, an endoscope device 20 may be provided, wherein a retainer 600 provided at the portion of the flexible tube 413 inserted into the passage 201 maintains the linear form of the flexible channel 200, and the endoscope device 20 is configured to prevent deformation of the flexible tube 413 when the assistant physician 2 holds the endoscopic surgical instruments and control device 420 with both hands.

[0185] Specific exemplary embodiments of the present invention have been described and illustrated above. However, the present invention is not limited to the exemplary embodiments described herein, and it will be apparent to those skilled in the art that various changes and modifications can be made without departing from the spirit and scope of the invention. Therefore, the modified or transformed examples should not be understood solely from the technical spirit or viewpoint of the present invention, and the transformed exemplary embodiments are part of the appended claims. Key reference numerals: 10, 20: endoscopic apparatus;

[0186] 100: Endoscope;

[0187] 200: Flexible channel;

[0188] 110: Insertion section;

[0189] 201: Passage;

[0190] 111: Objective lens;

[0191] 210: Installation components;

[0192] 112: Light source lens;

[0193] 300: Hat;

[0194] 113: Nozzle;

[0195] 301: First insertion hole;

[0196] 114: Channel;

[0197] 302: Second insertion hole;

[0198] 120: Control unit;

[0199] 303: Front surface;

[0200] 121: Knob;

[0201] 600: Holder;

[0202] 122: Fixture;

[0203] 610: Base;

[0204] 400: Assistive robot arm module; 611: Mounting slot;

[0205] 410: Assistive robotic arm;

[0206] 612: First mounting slot;

[0207] 411: Tweezers;

[0208] 613: Second mounting slot;

[0209] 412: Curved section;

[0210] 614: Inlet groove;

[0211] 412A: Connecting rod;

[0212] 620: Main body;

[0213] 412B: Tendon;

[0214] RF: Reference surface;

[0215] 413: Flexible tube;

[0216] 630: Extension section;

[0217] 420: Control device;

[0218] 640: Locking unit;

[0219] 421: Trigger;

[0220] 700: Monitor;

[0221] 422: Wheel;

[0222] 1: Surgical surgeon;

[0223] 500: Surgical Unit;

[0224] 2: Assistant Physician;

[0225] 510: Handle;

[0226] 3: The patient;

[0227] 520: Catheter;

[0228] 4: The affected area;

[0229] 530: Line.

Claims

1. An endoscopic device, comprising: An endoscope, the endoscope including a flexible insertion portion that is inserted into the human body; A flexible channel is attached to the insertion portion, such that a portion of it forms a passage along the longitudinal direction of the insertion portion; as well as An auxiliary arm, which is movably inserted into the passage and operated by a control device, The auxiliary arm includes: Tweezers capable of gripping human tissue, and A curved section, which is bent by the control device to pull the human tissue held by the forceps; The auxiliary arm includes a flexible tube connecting the bending portion and the control device; and The endoscopic device also includes a retainer that maintains the linear form of the flexible channel at the portion of the flexible tube inserted into the passage.

2. The endoscopic device according to claim 1, wherein, The curved portion forms a flexible joint structure.

3. The endoscopic device according to claim 2, wherein, The bending section includes multiple connecting rods and multiple tendons connected to the tweezers and sequentially penetrating the connecting rods.

4. The endoscope device of claim 1, wherein the auxiliary arm is rotatably inserted into the passage so as to be actuated in multiple degrees of freedom.

5. The endoscopic device according to claim 1, further comprising: A cap that connects the front end portion of the flexible channel to the front end portion of the insertion portion.

6. The endoscopic device according to claim 5, wherein, In the cap, there is a first insertion hole in which the front end portion of the insertion part is inserted and a second insertion hole in which the front end portion of the flexible channel is inserted.

7. The endoscopic device according to claim 6, wherein, The bearing or bushing is located between the outer surface of the front end portion of the flexible channel and the inner surface of the second insertion hole.

8. The endoscopic device according to claim 6, wherein, The front surface of the cap is tilted backward toward the second insertion hole based on the center of the first insertion hole.

9. The endoscope device of claim 1, wherein the retainer includes a base forming a linear mounting groove, the flexible channel being inserted into the linear mounting groove, and a body forming above the base and being gripped by a user to adjust the position and orientation of the mounting groove.

10. The endoscopic device according to claim 9, wherein, The bearing or bushing is located between the outer surface of the flexible channel and the inner surface of the mounting groove.

11. The endoscopic device of claim 9, wherein the body is symmetrically shaped based on a reference surface grasped by either of the hands, and The mounting slot includes a first mounting slot and a second mounting slot. The first mounting slot is spaced at an angle from the reference surface, and the second mounting slot is symmetrical to the first mounting slot based on the reference surface.

12. The endoscopic device of claim 1, wherein the retainer comprises a base to which the flexible channel is detachably coupled in the linear form, and a body formed above the base and held by the user.

13. The endoscopic device of claim 12, wherein the retainer includes an extension extending upward from the body for being wrapped between the thumb and forefinger by the user.

14. The endoscopic device according to claim 12, wherein, The retainer includes a locking portion extending from the body, and When the clamping force on the body is released, the retainer hangs on the index or ring finger that is holding the body by the locking part.

15. The endoscopic device according to claim 1, further comprising: A body-attachable fixation device that maintains the linear form of the flexible channel at the portion where the flexible tube is inserted into the passage.

16. The endoscopic device according to claim 15, wherein, The body attachment type fixation device includes an attachment base and an attachment member. The flexible channel is detachably connected to the attachment base in a linear form. The attachment member is connected to the attachment base and can be fixed to the wrist of an assistant physician or attached to the patient's body.

17. The endoscopic device of claim 1, wherein the flexible tube includes a fixing device that maintains the linear form of the flexible channel at the portion of the flexible tube inserted into the passage.

18. The endoscopic device according to claim 17, wherein, The fixation device includes an attachment base and an attachment member. The flexible channel is detachably connected to the attachment base in a linear form. The attachment member is connected to the attachment base and can be attached to a mobile tray-type temporary retainer or a surgical table.

19. The endoscopic device of claim 5, wherein the cap is made of a flexible material that is able to flatten upon contact with mucus within the organ, and the cap returns to its original form via the auxiliary arm as the auxiliary arm moves forward in the passage.

20. The endoscopic device of claim 1, wherein the forceps are formed in a widened and folded clamp-like shape, and Each of the clamp-like forms is longer than the other in order to keep the forceps flat on the tissue.

21. The endoscopic device according to claim 1, wherein, The curved portion is connected to the tweezers, and The forceps and the curved portion are not parallel to each other at their joint, so that the forceps can keep the tissue flat.

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