Lacrimal Endoscopy

Abstract

To provide a technology that when inspection or treatment is performed by inserting a lacrimal passage endoscope having a tubular insertion part having a length equal to or longer than a predetermined length into an organ of an inspection or treatment target, inhibits deformation of the insertion part.SOLUTION: A lacrimal passage endoscope comprises: a tubular insertion part capable of being inserted into a lacrimal passage; and an operation part that has a holding part for holding a base end of the insertion part and is capable of operating the insertion part. The insertion part has an outer diameter equal to or longer than 0.91 mm and equal to or shorter than 0.94 mm and is approximately uniform along its longer direction. The insertion part has a length equal to or longer than 30 mm and equal to or shorter than 60 mm. The insertion part has a degree of hardness equal to or higher than 400HV and equal to or lower than 450HV of Vickers hardness.SELECTED DRAWING: Figure 1

Description

[Technical field]

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

[0002] Lacrimal endoscopes used for the examination or treatment of lacrimal ducts have been developed (e.g., Patent Documents 1-2). Lacrimal endoscopes such as those shown in Patent Documents 1-2 are provided with an insertion section that can be inserted into a 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 Summary of the Invention [Problem to be solved by the invention]

[0004] When the tubular insertion part of a lacrimal endoscope is used for the examination or treatment of an organ such as the nasolacrimal duct, it is considered that a foreign body (e.g., a protein mass) stuck in the organ such as the nasolacrimal duct is pushed out by the tip of the insertion part. In such a case, it is considered that a bending moment is generated in the insertion part when the insertion part pushes out the foreign body. Here, the length of the insertion part used for the examination or treatment of the nasolacrimal duct is long enough to reach from the lacrimal punctum to the opening of the nasolacrimal duct. Therefore, the degree of the bending moment acting on the insertion part becomes large. Therefore, the insertion part may be deformed.

[0005] Therefore, an object of the present invention is to provide a technology that suppresses deformation of the tubular insertion portion of a lacrimal endoscope that has a predetermined length or more and is inserted into an organ to be examined or treated for examination or treatment. [Means for solving the problem]

[0006] In order to solve the above-mentioned problems, the present invention employs the following configuration.

[0007] 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, wherein the outer diameter of the insertion portion is 0.91 mm or more and 0.94 mm or less and is approximately uniform along the longitudinal direction, the length of the insertion portion is 30 mm or more and 60 mm or less, and the hardness of the insertion portion is Vickers hardness 400 HV or more and 450 HV or less.

[0008] According to this configuration, the user can insert the insertion part into the patient's lacrimal duct and reach the organ to be examined or treated. Therefore, the path from the lacrimal punctum to the organ to be examined or treated, and the organ to be examined or treated itself can be examined or treated. Furthermore, according to this configuration, the length of the insertion part is 30 mm or more and 60 mm or less. Therefore, for example, when pushing out a foreign body stuck in the organ to be examined or treated with the tip of the insertion part, a large bending moment may be generated in the insertion part. However, the outer diameter of the insertion part in this configuration is 0.91 mm or more and 0.94 mm or less, and the hardness of the insertion part is 400 HV or more and 450 HV or less in Vickers hardness. Therefore, the entire insertion part is prevented from being deformed by the bending moment acting on the insertion part.

[0009] In addition, according to this configuration, the outer diameter of the insertion portion is approximately uniform along the longitudinal direction. Compared to a case where the insertion portion is tapered so that its outer diameter increases from the tip to the base end, the insertion portion can be smoothly delivered to the organ to be examined or treated.

[0010] 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.

[0011] According to this configuration, the length of the insertion part is 30 mm or more and 60 mm or less. Therefore, for example, when a foreign body stuck in an organ to be examined or treated is pushed out with the tip of the insertion part, a large bending moment may be generated in the insertion part. A bending moment larger than the bending moment generated at the tip or center of the insertion part acts on the base end of the insertion part. 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, so that the deformation of the base end of the insertion part is suppressed.

[0012] According to this configuration, the outer diameter of the insertion portion is 0.91 mm or more and 0.94 mm or less, and the hardness of the insertion portion is 400 HV or more and 450 HV or less in Vickers hardness. Therefore, when a bending moment acts on the tip of the insertion portion, it is expected that the deformation at the center of the insertion portion is suppressed, while the load is concentrated at the base end of the insertion portion. However, according to this configuration, the deformation of the base end of the insertion portion is suppressed by the elastic member covering the outer surface of the base end of the insertion portion.

[0013] In the lacrimal endoscope according to the above aspect, the lacrimal endoscope may further include 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, and the insertion portion, the first tube, and the second tube may each be formed from a material including metal.

[0014] According to this configuration, the insertion portion, the first tube, and the second tube are each made of a material containing metal, which improves the rigidity of the insertion portion, the first tube, and the second tube, thereby suppressing deformation of the insertion portion, the first tube, and the second tube.

[0015] In the lacrimal endoscope according to the above aspect, the first tube and the second tube may be provided so as to be in contact with an inner wall of the insertion portion and to be in contact with each other.

[0016] According to this configuration, the first tube and the second tube are provided so as to contact the inner wall of the insertion portion, respectively, and so as to contact each other. Therefore, the insertion portion, the first tube, and the second tube can integrally resist the bending moment generated in the insertion portion. Therefore, deformation of the insertion portion, the first tube, and the second tube is suppressed.

[0017] In the lacrimal endoscope according to the above aspect, the first tube and the second tube are arranged side by side in the radial direction of the insertion portion, 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.

[0018] 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.

[0019] In the lacrimal endoscope according to the above aspect, the ratio of the Vickers hardness of the insertion portion to the outer diameter of the insertion portion may be in the range of 421 to 500, and the ratio of the Vickers hardness of the insertion portion to the length of the insertion portion may be in the range of 6 to 15.

[0020] If the ratio of the Vickers hardness of the insertion part to the outer diameter of the insertion part is within the above range, and the ratio of the Vickers hardness of the insertion part to the length of the insertion part is within the above range, the device to be inspected or treated is Even if a bending moment occurs in the insertion part when the tip of the insertion part is used to push out a protein mass that has clogged a tract, the hardness of the insertion part can be secured to be sufficient to withstand the value of the bending moment that occurs, thereby suppressing deformation of the insertion part. Effect of the Invention

[0021] According to the present invention, a technology can be provided that suppresses deformation of the tubular insertion portion of a lacrimal endoscope when the tubular insertion portion is longer than a predetermined length and is inserted into an organ to be examined or treated for examination or treatment. [Brief description of the drawings]

[0022] [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

[0023] 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.

[0024] 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 about 30 mm to 60 mm and an outer diameter of about 0.91 mm.

[0025] 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).

[0026] 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.

[0027] 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.

[0028] 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.

[0029] 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. At the end, a lens 11 is provided.

[0030] 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.

[0031] The insertion section 2 has a channel pipe 12 inside the outer pipe 7. The channel pipe 12 is a cylindrical member made of stainless steel with high rigidity, 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 are each members formed of a metal material with high rigidity, and can be integrated to resist the bending moment generated in the insertion section 2. Thus, the deformation of the insertion section 2, the image fiber pipe 9, and the channel pipe 12 is suppressed. The hardness of such an insertion section 2 is a Vickers hardness of 400HV or more and 450HV or less. The channel pipe 12 is also an example of the "second pipe" of the present invention.

[0032] 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.

[0033] 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.

[0034] 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.

[0035] Here, when the tip of the insertion portion 2 is inserted into the lacrimal canaliculus 52, lacrimal sac 53, or nasolacrimal duct 54 (described later) for examination or treatment, if there is a foreign body (e.g., a protein lump) stuck in these organs, it is considered that the tip of the insertion portion will push out the foreign body. In such a case, since the length of the insertion portion 2 is long, about 30 mm to 60 mm, it is considered that a large bending moment will be generated in the insertion portion 2. In particular, it is considered that a bending moment larger than the bending moment generated at the tip and center of the insertion portion 2 will be 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.

[0036] The outer diameter of the insertion portion 2 is about 0.91 mm, and the hardness of the insertion portion 2 is about Vickers hardness 400 HV or more and 450 HV or less. Therefore, when a bending moment acts on the tip of the insertion portion 2, it is expected that deformation at the center of the insertion portion 2 is suppressed, while the load is concentrated at the base end of the insertion portion 2. However, the elastic deformation of the damper 15 covering the outer surface of the base end of the insertion portion 2 suppresses deformation of the base end of the insertion portion 2.

[0037] 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 part 2 from one of two lacrimal puncta 51 located near the eye to the lacrimal canaliculus 52. Here, for example, according to "Importance of Endoscopes in Lacrimal Surgery, Katsuaki Kurihashi, Head and Neck Surgery, Vol. 8, No. 1," the sum of the total length of the lacrimal canaliculus 52 and the length of the lacrimal sac 53 is, for example, about 16 mm to 30 mm. Therefore, when the insertion part 2, which has a total length of, for example, about 30 mm, is further inserted, the tip of the insertion part 2 reaches the lacrimal sac 53. Also, when the total length of the insertion part 2 is, for example, about 60 mm, which is longer than 30 mm, when the insertion part 2 is further inserted, the tip of the insertion part 2 reaches the opening of the nasolacrimal duct 54 located further back in the lacrimal sac 53.

[0038] Here, when the insertion portion 2 is inserted into the lacrimal canaliculus 52, the lacrimal sac 53, or the nasolacrimal duct 54, it is considered that a foreign body (e.g., a protein lump) stuck in these organs is pushed out by the tip of the insertion portion 2. In such a case, since the entire length of the insertion portion 2 is long, about 30 mm to 60 mm, a large bending moment may be generated in the insertion portion 2. However, the outer diameter of the insertion portion 2 is about 0.91 mm, and the hardness of the insertion portion 2 is a Vickers hardness of 400 HV or more and 450 HV or less. Therefore, deformation of the entire insertion portion 2 due to the bending moment acting on the insertion portion 2 is suppressed.

[0039] Also, while the insertion section 2 reaches the lacrimal canaliculus 52, the lacrimal sac 53, or the nasolacrimal duct 54, the light passing through the light guide 8 irradiates the inner wall surface of the lacrimal canaliculus 52, the lacrimal sac 53, or the nasolacrimal duct 54. Then, the light reflected on the inner wall surface of the lacrimal canaliculus 52, the lacrimal sac 53, or the nasolacrimal duct 54 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 inner wall surface of the lacrimal canaliculus 52, the lacrimal sac 53, or the nasolacrimal duct 54 is formed from the transmitted light. Thus, the lacrimal canaliculus 52, the lacrimal sac 53, or the nasolacrimal duct 54 can be examined or treated.

[0040] Furthermore, while the insertion portion 2 is being inserted toward the nasolacrimal duct 54, the user can operate the water passage 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 passage channel 13 on the insertion portion 2 side. By such an operation, physiological saline flows into the lacrimal canaliculus 52, which is expanded. Thus, the insertion portion 2 is smoothly inserted into the lacrimal canaliculus 52. Furthermore, the outer diameter of the insertion portion 2 is not tapered but is substantially uniform, which also allows the insertion portion 2 to be smoothly inserted into the lacrimal canaliculus 52.

[0041] In addition, the lacrimal canaliculus 52 is washed with physiological saline, so that images of the lacrimal canaliculus 52, the lacrimal sac 53, or the nasolacrimal duct 54 can be obtained more clearly.

[0042] <Other embodiments> The length of the insert 2 is set so that the ratio of the Vickers hardness of the insert 2 to the outer diameter of the insert 2 is 6 to 100 mm. The length of the insertion portion 2 may be set in the range of 30 mm to 60 mm so as to be within the range of 15 times. When the length of the insertion portion 2 is set in this manner, even if a foreign body stuck in an organ such as the nasolacrimal duct 54 is pushed out with the tip of the insertion portion 2, the hardness of the insertion portion 2 can be secured to be sufficiently large against the value of the bending moment acting on the insertion portion 2 when pushing out the foreign body. Therefore, deformation of the insertion portion 2 is suppressed.

[0043] The outer diameter of the insertion portion 2 may be in the range of 0.91 mm or more and 0.94 mm or less. When the range of the outer diameter 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 Vickers hardness of the insertion portion 2 to the outer diameter of the insertion portion 2 falls within the range of 421 to 500. When the outer diameter of the insertion portion 2 is set in this manner, even if a foreign body stuck in an organ such as the nasolacrimal duct 54 is pushed out with the tip of the insertion portion 2, the hardness of the insertion portion 2 can be secured to be sufficiently large against the value of the bending moment acting on the insertion portion 2 when pushing out the foreign body. Therefore, deformation of the insertion portion 2 is suppressed.

[0044] 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.

[0045] The embodiments and modifications disclosed above can be combined with each other. [Explanation of symbols]

[0046] 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 0.91 mm and equal to or less than 0.94 mm, and is substantially uniform along the longitudinal direction. The length of the insertion portion is 30 mm or more and 60 mm or less, The hardness of the insertion portion is 400 HV or more and 450 HV or less in Vickers hardness, the holding portion has a hole through which the base end of the insertion portion can be inserted, and an elastic member provided so as to cover an outer surface of the base end of the insertion portion, A gap provided between an outer wall of the insertion portion and an inner wall of the hole is filled with the elastic member. 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 insert, the first tube, and the second tube are each formed from a material including a metal; The lacrimal endoscope according to claim 1 .

3. 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 2 .

4. 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 or 3.

5. A tubular insertion part that can be inserted into a 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 holding portion has a hole through which the base end of the insertion portion can be inserted, and an elastic member provided so as to cover an outer surface of the base end of the insertion portion, A gap provided between an outer wall of the insertion portion and an inner wall of the hole is filled with the elastic member. Lacrimal endoscopy.

Images