Lacrimal Endoscopy

Abstract

The present invention is a lacrimal passage endoscope equipped with tubular insertion portion that can be inserted into a lacrimal passage and an operating portion that has a holding portion for holding the base end of the insertion portion and can operate the insertion portion. The outer diameter of the insertion portion is 0.6-0.7 mm inclusive and is substantially uniform along the longitudinal direction, and the length of the insertion portion is from 16-40 mm inclusive.

Description

[Technical field]

[0001] The present invention relates to a lacrimal endoscope. [Background technology]

[0002] Lacrimal endoscopes used for the examination or treatment of the lacrimal duct have been developed (e.g., Patent Documents 1-3). Lacrimal endoscopes such as those shown in Patent Documents 1-3 are provided with an insertion section that can be inserted into the patient's lacrimal duct. The insertion section is tubular, and at its tip, a light that illuminates the subject to be examined and an objective lens that focuses light reflected from the surface of the subject to be examined are provided. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] Patent No. 4124423 [Patent Document 2] Patent No. 6180449 [Patent Document 3] Patent application No. 2018-215006 Summary of the Invention [Problem to be solved by the invention]

[0004] If the outer diameter of the insertion part is the value shown in Patent Documents 1-3, the user may find it difficult to insert the insertion part into the patient's lacrimal duct. Therefore, it is considered to make the insertion part thinner. On the other hand, if the length of the insertion part is the value shown in Patent Documents 1-3, it is difficult to operate the insertion part, and it is considered that the tip of the insertion part gets caught on the inner wall of the lacrimal duct while inserting the insertion part into the lacrimal duct, and presses against the inner wall of the lacrimal duct.

[0005] In such a case, a bending moment may be generated in the insertion part due to a force acting from the inner wall of the lacrimal duct to the tip of the insertion part. If the insertion part is narrowed as described above, the possibility of deformation of the insertion part may increase. If the insertion part is deformed, there is a risk of inconvenience such as the insertion part being unable to be inserted into the lacrimal duct or parts installed inside the insertion part being damaged.

[0006] Therefore, an object of the present invention is to provide a technique for improving the operability of a lacrimal endoscope and suppressing deformation of the shape of the lacrimal endoscope. [Means for solving the problem]

[0007] In order to solve the above-mentioned problems, the present invention employs the following configuration.

[0008] That is, a lacrimal endoscope according to one aspect of the present invention comprises a tubular insertion portion that can be inserted into a lacrimal duct, and an operating portion that has a holding portion that holds the base end of the insertion portion and can operate the insertion portion, the outer diameter of the insertion portion is 0.6 mm or more and 0.7 mm or less and is approximately uniform along the longitudinal direction, and the length of the insertion portion is 16 mm or more and 40 mm or less.

[0009] According to this configuration, the outer diameter of the insertion part is thin and substantially uniform, so that the user can easily insert the insertion part into the patient's lacrimal duct. In addition, the length of the insertion part is short, so that the operability of the insertion part is improved. Therefore, the tip of the insertion part is prevented from getting caught on the inner wall of the lacrimal duct while being inserted into the lacrimal duct. Even if the tip of the insertion part gets caught on the inner wall of the lacrimal duct, the length of the insertion part is short, so that the bending moment generated in the insertion part is small due to a reaction force from the inner wall of the lacrimal duct to the tip of the insertion part. Therefore, deformation of the lacrimal endoscope is suppressed.

[0010] The lacrimal endoscope according to the above aspect further includes a first tube provided inside the insertion portion along the longitudinal direction of the insertion portion, through which light incident from the tip of the insertion portion passes, and a second tube provided inside the insertion portion along the longitudinal direction of the insertion portion, through which fluid flowing out from the tip of the insertion portion passes, wherein the insertion portion, the first tube, and the second tube are each made of a material containing metal, and the first tube and the second tube are each provided so as to be in contact with an inner wall of the insertion portion and with each other.

[0011] According to this configuration, the insertion portion, the first tube, and the second tube are each made of a material containing metal, so that the rigidity of the insertion portion, the first tube, and the second tube is improved. Furthermore, the first tube and the second tube are arranged so as to be in contact with the inner wall of the insertion portion, respectively, and to be in contact with each other. Therefore, the insertion portion, the first tube, and the second tube can cooperate to resist the bending moment generated in the insertion portion. Therefore, deformation of the insertion portion, the first tube, and the second tube is suppressed.

[0012] In the lacrimal endoscope according to one aspect described above, the first tube and the second tube are arranged side by side in the radial direction of the insertion portion, and a cross section of the second tube perpendicular to the longitudinal direction is approximately semicircular, and a straight portion of the approximately semicircular shape may be in contact with the first tube.

[0013] According to this configuration, the cross-sectional area of ​​the second tube can be increased without changing the thickness of the insertion portion, thereby increasing the flow rate of the fluid passing through the second tube.

[0014] In the lacrimal endoscope according to the above aspect, the holding portion may have an elastic member provided so as to cover an outer surface of the base end of the insertion portion.

[0015] When the tip of the insertion part gets caught on the inner wall of the lacrimal duct and presses against the inner wall, a force acts from the inner wall of the lacrimal duct to the tip of the insertion part, causing a bending moment in the insertion part. The magnitude of the bending moment generated at the base end of the insertion part is greater than the magnitude of the bending moment generated at the tip or center of the insertion part. Therefore, it is considered that the possibility of deformation of the base end of the insertion part increases. However, according to this configuration, when the base end of the insertion part tries to deform, the elastic member covering the outer surface of the base end of the insertion part deforms, and deformation of the base end of the insertion part is suppressed.

[0016] In the lacrimal endoscope according to the above aspect, the ratio of the length of the insertion portion to the outer diameter of the insertion portion may be in the range of 22 to 37.

[0017] If the ratio of the length of the insertion part to the outer diameter of the insertion part is within the above range, even if the tip of the insertion part gets caught on the inner wall of the lacrimal duct and a force acts from the inner wall of the lacrimal duct to the tip of the insertion part, causing a bending moment in the insertion part, it is possible to ensure an outer diameter of the insertion part that is sufficiently large relative to the value of the bending moment that has occurred, thereby suppressing deformation of the insertion part. Effect of the Invention

[0018] According to the present invention, it is possible to provide a technology that improves the operability of a lacrimal endoscope and suppresses deformation of the shape of the lacrimal endoscope. [Brief description of the drawings]

[0019] [Figure 1] FIG. 1 shows an example of the configuration of a lacrimal endoscope according to an embodiment. [Diagram 2] FIG. 2 shows a schematic enlarged view of the tip of the insertion section. [Diagram 3] FIG. 3 illustrates a partially enlarged cross-sectional view of the holding portion. [Figure 4] FIG. 4 shows the situation when a lacrimal endoscope is used. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0020] DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The following describes an embodiment of the present invention. The embodiment described below is an example of the present invention, and the technical scope of the present invention is not limited to the following aspect.

[0021] Fig. 1 shows an example of the configuration of a lacrimal endoscope 1 according to an embodiment of the present invention. As shown in Fig. 1, the lacrimal endoscope 1 includes an insertion section 2. The outer shape of the insertion section 2 is formed by a highly rigid stainless steel outer pipe 7 (detailed in Fig. 2). The outer pipe 7 is a cylindrical member with a total length of 18 mm and an outer diameter of 0.7 mm.

[0022] The size of the outer diameter is approximately uniform over the entire length of the outer pipe 7. The outer pipe 7 has a portion that extends linearly from the base end toward the tip end, and a portion that curves in a predetermined direction while extending. Since the insertion portion 2 has a small and approximately uniform outer diameter, it can be easily inserted into the patient's lacrimal canaliculus 52 (see FIG. 4 described later).

[0023] The lacrimal endoscope 1 also includes an operation unit 3 capable of operating the insertion portion 2. The operation unit 3 has a thickness that allows a user to hold it. The operation unit 3 also includes a holding unit 4 that holds and fixes the base end of the insertion portion 2.

[0024] A user grips the operation unit 3 to operate the insertion portion 2, and since the length of the insertion portion 2 is short at 18 mm, the user feels that the operability of the insertion portion 2 is high. Therefore, the tip of the insertion portion 2 is prevented from getting caught on the inner wall of the lacrimal canaliculus 52 while the insertion portion 2 is being inserted into the lacrimal canaliculus 52. Even if the tip of the insertion portion 2 gets caught on the inner wall of the lacrimal canaliculus 52, the length of the insertion portion 2 is short, so that the bending moment generated in the insertion portion 2 due to the force acting from the inner wall of the lacrimal canaliculus 52 to the tip of the insertion portion 2 is small. Therefore, deformation of the lacrimal endoscope 1 is suppressed.

[0025] The operation unit 3 also includes a first connection unit 5 to which a supply tube through which physiological saline (an example of a fluid of the present invention) supplied from an external device passes is connected, and the operation unit 3 also includes a second connection unit 6 to which a transmission cable for transmitting and receiving light between the operation unit 3 and an external imaging system is connected.

[0026] FIG. 2 shows an outline of an enlarged view of the tip of the insertion section 2 as viewed from the longitudinal direction. As shown in FIG. 2, the insertion section 2 has a light guide 8 inside the outer pipe 7. The light guide 8 is, for example, a bundle of a plurality of illumination optical fibers, and is provided along the longitudinal direction of the outer pipe 7. The light guide 8 also extends to the inside of the operation section 3, and its tip is connected to the second connection section 6. That is, light supplied from an external imaging system via the second connection section 6 passes through the inside of the light guide 8. The light that passes through the light guide 8 illuminates the surface of the observation object.

[0027] The insertion section 2 also has an image fiber pipe 9 inside the outer pipe 7. The image fiber pipe 9 is a cylindrical member made of stainless steel with high rigidity, and is provided so as to contact the inner wall of the outer pipe 7. A plurality of image fibers 10 are provided inside the image fiber pipe 9 along the longitudinal direction. A lens 11 is provided at the tip of the image fiber pipe 9.

[0028] The lens 11 collects the light that is irradiated from the tip of the light guide 8 and reflected on the surface of the observation object. The light collected by the lens 11 passes through the image fiber 10. The image fiber 10 also extends to the inside of the operation unit 3, and its tip is connected to the second connection unit 6. In other words, the light that passes through the image fiber 10 is transmitted to an external imaging system. Here, the image fiber pipe 9 is an example of the "first pipe" of the present invention.

[0029] The insertion section 2 has a channel pipe 12 inside the outer pipe 7. The channel pipe 12 is a highly rigid stainless steel cylindrical member, and the cross section perpendicular to the longitudinal direction has a substantially semicircular shape. The channel pipe 12 is arranged to be aligned with the image fiber pipe 9 in the radial direction of the outer pipe 7. The channel pipe 12 is arranged so that the substantially semicircular straight portion is in contact with the outer surface of the image fiber pipe 9, and the substantially semicircular arc portion is in contact with the inner wall of the outer pipe 7. Thus, the insertion section 2, the image fiber pipe 9, and the channel pipe 12 can counter the bending moment generated in the insertion section 2 as a whole. Thus, the deformation of the insertion section 2, the image fiber pipe 9, and the channel pipe 12 is suppressed. The channel pipe 12 is an example of the "second pipe" of the present invention.

[0030] A water passage channel 13 is provided inside the channel pipe 12 along the longitudinal direction. The water passage channel 13 extends into the inside of the operation section 3, and its tip is connected to the first connection section 5. That is, physiological saline supplied from an external device via the first connection section 5 flows into the water passage channel 13. The physiological saline can flow out from the tip of the water passage channel 13 on the insertion section 2 side to the outside. Although not shown, the operation section 3 is provided with a water passage operation section for performing an operation of causing physiological saline to flow in from the external device via the first connection section 5 and causing it to flow out from the tip of the water passage channel 13 on the insertion section 2 side to the outside.

[0031] Here, the cross section of the channel pipe 12 perpendicular to the longitudinal direction is substantially semicircular, and a straight portion of the substantially semicircular shape is in contact with the outer surface of the image fiber pipe 9. By making the cross section of the channel pipe 12 substantially semicircular in this manner, the cross-sectional area of ​​the channel pipe 12 can be made larger without changing the diameter of the outer pipe 7 of the insertion section 2, compared to the case where a channel pipe 12 with a circular cross section is used. Therefore, the flow path area of ​​the water passage channel 13 can be made larger, and the flow rate of physiological saline passing through the water passage channel 13 can be increased.

[0032] Fig. 3 illustrates a partially enlarged view of a cross section parallel to the longitudinal direction of the holding portion 4. As shown in Fig. 3, the holding portion 4 has a hole 14 through which the base end of the insertion portion 2 can be inserted. A gap is provided between the outer wall of the insertion portion 2 and the inner wall of the hole 14 in the radial direction of the insertion portion 2, and the gap is filled by a damper 15. The damper 15 is an elastic member that can expand and contract in the radial direction of the insertion portion 2.

[0033] Here, when the tip of the insertion portion 2 gets caught on the inner wall of the lacrimal canaliculus 52 and a force acts from the inner wall of the lacrimal canaliculus 52 to the tip of the insertion portion 2, it is considered that a bending moment larger than the bending moment occurring at the tip or center of the insertion portion 2 is generated at the base end of the insertion portion 2. Therefore, it is considered that the base end of the insertion portion 2 is more easily deformed than the tip or center of the insertion portion 2. However, when the base end of the insertion portion 2 tries to deform, the damper 15 elastically deforms, thereby suppressing the deformation of the base end of the insertion portion 2.

[0034] Next, an example of use of the lacrimal endoscope 1 will be described. FIG. 4 shows a situation in which the lacrimal endoscope 1 is used. The user holds the operation unit 3 of the lacrimal endoscope 1 and inserts the tip of the insertion unit 2 from one of two lacrimal puncta 51 located near the eye to the lacrimal canaliculus 52. Here, according to "Importance of Endoscopes in Lacrimal Surgery, Katsuaki Kurihashi, Head and Neck Surgery, Vol. 8, No. 1," for example, the sum of the total length of the lacrimal canaliculus 52 and the width of the lacrimal sac 53 is, for example, about 12 mm to 16 mm. Therefore, if the insertion unit 2, which has a total length of about 18 mm, is further inserted, the tip of the insertion unit 2 will reach the lacrimal sac 53.

[0035] Here, while the insertion portion 2 is inserted into the lacrimal canaliculus 52, the light passing through the light guide 8 irradiates the inner wall surface of the lacrimal canaliculus 52 or the lacrimal sac 53. Then, the light reflected on the inner wall surface of the lacrimal canaliculus 52 or the lacrimal sac 53 is collected via the lens 11. The light collected by the lens 11 passes through the image fiber 10. Then, the light passing through the image fiber 10 is transmitted to an external imaging system. Then, in the external imaging system, an image of the outer wall surface of the lacrimal canaliculus 52 or the lacrimal sac 53 is formed from the transmitted light.

[0036] Furthermore, while the insertion portion 2 is inserted into the lacrimal canaliculus 52, the user can operate the water flow operation portion of the operation unit 3 to cause physiological saline to flow in from an external device via the first connection portion 5 and cause the physiological saline to flow out from the tip of the water flow channel 13 on the insertion portion 2 side. By such an operation, physiological saline flows into the lacrimal canaliculus 52, and the lacrimal canaliculus 52 is expanded. Thus, the insertion portion 2 is smoothly inserted into the lacrimal canaliculus 52. Furthermore, the lacrimal canaliculus 52 is washed with physiological saline. Thus, a clearer image of the lacrimal canaliculus 52 or the lacrimal sac 53 can be obtained.

[0037] <Other embodiments> In the above embodiment, the total length of the insertion portion 2 is 18 mm, but the total length of the insertion portion 2 may be in the range of 16 mm to 40 mm. In the above embodiment, the inner wall surface of the lacrimal canaliculus 52 or the lacrimal sac 53 is imaged as shown in Fig. 4, but by setting the total length of the insertion portion 2 in the range of 16 mm to 40 mm, which is longer than in the above embodiment, it becomes possible to insert the insertion portion 2 into the nasolacrimal duct 54 (Fig. 4) and preferably image the inner wall surface of the nasolacrimal duct 54.

[0038] The outer diameter of the insertion portion 2 may be in the range of 0.6 mm to 0.7 mm. When the range of the total length of the insertion portion 2 is determined as described above, the outer diameter of the insertion portion 2 may be set so that the ratio of the length of the insertion portion 2 to the outer diameter is in the range of 22 to 37. When the outer diameter of the insertion portion 2 is set in this manner, the ratio of the length of the insertion portion 2 to the outer diameter is suppressed, so that even if the tip of the insertion portion 2 gets caught on the inner wall of the lacrimal canaliculus 52 and a bending moment is generated in the insertion portion 2, the outer diameter of the insertion portion can be secured to be sufficiently large for the value of the generated bending moment. Therefore, deformation of the insertion portion 2 is suppressed. The above ratio of 22 corresponds to the case where the outer diameter of the outer pipe 7 is 0.7 mm and the total length is 16 mm. The above ratio of 37 corresponds to the case where the outer diameter of the outer pipe 7 is 0.6 mm and the total length is 22 mm (the sum of the maximum value of the sum of the total length of the lacrimal canaliculus 52 and the width of the lacrimal sac 53, which is 16 mm, and the minimum length of the lacrimal sac, which is 6 mm).

[0039] Moreover, the outer pipe 7, the image fiber pipe 9, and the channel pipe 12 may be formed of a metal material other than stainless steel. Moreover, at least one of the outer pipe 7, the image fiber pipe 9, and the channel pipe 12 does not have to be made of metal. Moreover, the inner wall of the outer pipe 7, the outer wall of the image fiber pipe 9, and the outer wall of the channel pipe 12 do not have to be provided so as to be in contact with each other, and the cross-sectional shape of the channel pipe 12 in the longitudinal direction does not have to be semicircular. Moreover, the damper 15 does not have to be provided around the base end of the insertion section 2 in the holding section 4.

[0040] The embodiments and modifications disclosed above can be combined with each other. [Explanation of symbols]

[0041] 1: Lacrimal Endoscopy 2: Insertion section 3: Control section 4: Holding part 5: First connection 6: Second connection part 7: Outer pipe 8: Light guide 9: Image fiber pipe 10: Image fiber 11: Lens 12: Channel Pipe 13: Water channel 14: Hole 15: Damper 51: Punctum 52: Lacrimal canaliculus 53: Lacrimal sac 54: Nasolacrimal duct

Claims

1. A tubular insertion part that can be inserted into the lacrimal duct; an operation unit having a holding unit for holding a base end of the insertion unit and capable of operating the insertion unit, The outer diameter of the insertion portion is equal to or greater than 0.6 mm and equal to or less than 0.7 mm, and is substantially uniform along the longitudinal direction. The length of the insertion portion is 16 mm or more and 40 mm or less. Lacrimal endoscopy.

2. a first tube provided inside the insertion portion along a longitudinal direction of the insertion portion, the first tube through which light incident from a tip of the insertion portion passes; A second tube is provided inside the insertion portion along the longitudinal direction of the insertion portion, and through which a fluid flowing out from the tip of the insertion portion passes, the insertion portion, the first tube, and the second tube are each made of a material including a metal; The first tube and the second tube are provided so as to be in contact with an inner wall of the insertion portion and to be in contact with each other. The lacrimal endoscope according to claim 1 .

3. The first tube and the second tube are arranged side by side in a radial direction of the insertion portion, A cross section of the second tube perpendicular to the longitudinal direction is substantially semicircular, The substantially semicircular straight portion is in contact with the first tube. The lacrimal endoscope according to claim 2 .

4. The holding portion has an elastic member provided so as to cover an outer surface of the base end of the insertion portion. A lacrimal endoscope according to any one of claims 1 to 3.

5. The ratio of the length of the insert to the outer diameter of the insert is in the range of 22 to 37; The lacrimal endoscope according to any one of claims 1 to 4.

Images