Endoscope and endoscope system
The endoscope's slidable protective tube design prevents rotation of the insertion portion, maintaining the initial top and bottom direction setting, thus addressing the issue of endoscope rotation within treatment tools.
Patent Information
- Application Number
- PCT/JP2024/033872
- Authority / Receiving Office
- WO · WO
- Patent Type
- Applications
- Current Assignee / Owner
- Priority Date
- 2023-09-29
- Filing Date
- 2024-09-24
- Publication Date
- 2025-04-03
AI Technical Summary
When using an endoscope inserted into a treatment tool, the endoscope can rotate inside the tool, causing the top and bottom directions to become unknown, necessitating the endoscope to be removed and reinserted to restore the initial setting.
The endoscope features a protective tube that is slidable relative to the insertion portion, preventing the insertion portion from rotating with the protective tube, thus maintaining the initial setting of the top and bottom direction.
This configuration ensures that the initial setting of the endoscope's top and bottom direction is maintained, preventing unnecessary disassembly and reassembly, and reducing user burden.
Smart Images

Figure JP2024033872_03042025_PF_FP_ABST
Abstract
Description
Endoscopes and Endoscope Systems
[0001] The present invention relates to an endoscope and an endoscope system.
[0002] Endoscope systems for observing the inside of a body have been widely used. Endoscopes, for example, include an insertion section inserted into the body and a base section, an imaging element and a light source built into the distal end of the insertion section, cables for these components running from the insertion section to the base section, and a protective tube attached to the base section to protect the cables. Endoscopes are sometimes used by inserting the insertion section into a treatment tool. For example, Patent Document 1 discloses an endoscopic treatment tool including a guide pipe into which the insertion section of the endoscope is inserted and a guide sheath attached to the distal end of the pipe, and an endoscopic system using the treatment tool.
[0003] Patent No. 6082169
[0004] When an endoscope is inserted into a treatment tool and used, the endoscope is set up with its orientation specified. However, if the protective tube of the endoscope is grasped while using the treatment tool, the endoscope may rotate inside the treatment tool, making it impossible to determine its orientation. In this case, the endoscope must be removed from the treatment tool and set up again. Furthermore, because the protective tube is located in an easy-to-grasp position, it is sometimes necessary to grasp the protective tube to change the orientation of the endoscope.
[0005] The endoscope according to the present invention is an endoscope having an insertion section that has an outer tube that houses a cable and is inserted into the body, and a base section, wherein the base section has a connector section to which a cable extending from the base end of the insertion section toward the base section is connected, and a protective tube that is provided from the connector section to the base end of the insertion section and covers the cable, and the protective tube is not fixed to the insertion section or the cable, but is configured to be slidable relative to the insertion section.
[0006] According to the above configuration, even if an operation to rotate the protective tube is performed, the protective tube is prevented from rotating freely and the insertion section is prevented from rotating accordingly, thereby maintaining the initial setting state in which the top-bottom orientation of the endoscope is specified.
[0007] In the endoscope according to the present invention, it is preferable that the base section houses the base end of the insertion section and the cable and has a second protective tube arranged within the protective tube, the gap between the insertion section and the second protective tube is sealed with adhesive, and the protective tube is not fixed to the second protective tube but is configured to be slidable relative to the second protective tube.
[0008] According to the above configuration, the adhesive filled in the gap between the insertion portion and the second protective tube can prevent water and other substances from entering the inside of the endoscope, and by imparting sliding properties between the protective tubes, the effect of suppressing rotation of the insertion portion can be ensured.
[0009] In the endoscope according to the present invention, it is preferable that an imaging element is built into the distal end of the insertion section, in which case the endoscope can be made thinner and clearer images can be obtained.
[0010] The endoscopic system according to the present invention comprises the above-mentioned endoscope and an endoscopic treatment tool, wherein the endoscopic treatment tool comprises a catheter shaft having a first channel through which the endoscope is inserted and a second channel used for a predetermined treatment, a handle provided at the base end of the catheter shaft, and a first tube that constitutes the first channel and extends from the base end side of the handle, and the first tube is provided with a locking portion that fixes the relative movement of the endoscope with respect to the catheter shaft.
[0011] According to the above configuration, the function of the locking section prevents the endoscope from rotating within the first channel, and the synergistic effect with the structure of the protective tube makes it possible to more reliably maintain the initial setting state in which the endoscope is oriented up and down.
[0012] The endoscope and endoscope system according to the present invention are simple to operate and easy to use, and can reduce the burden on the doctor who uses them.
[0013] 7 is a diagram showing the overall configuration of an endoscopic system that is an example of an embodiment; FIG. 8 is a perspective view of an endoscopic treatment tool that is an example of an embodiment; FIG. 9 is a diagram showing the distal end surface of a catheter shaft of the endoscopic treatment tool; FIG. 10 is a diagram showing a base end side portion of the endoscopic treatment tool; FIG. 11 is an exploded perspective view of a handle of the endoscopic treatment tool; FIG. 12 is a diagram showing an endoscope that is an example of an embodiment; FIG. 13 is a cross-sectional view of a portion of the endoscope that has a protective tube cut in the length direction; FIG. 14 is a cross-sectional view taken along line AA in FIG. 11; FIG. 15 is a diagram showing an example of use of the endoscopic system that is an example of an embodiment.
[0014] Hereinafter, an example of an embodiment of an endoscope and an endoscope system according to the present invention will be described in detail with reference to the drawings. The embodiment described below is merely an example, and the present invention is not limited to the following embodiment. Furthermore, the present invention includes forms formed by selectively combining multiple embodiments and modified examples described below.
[0015] Fig. 1 is a perspective view showing the overall configuration of an endoscopic system 1, which is an example of an embodiment. As shown in Fig. 1, the endoscopic system 1 includes an endoscope 10 and an endoscopic treatment tool 20, and is configured so that the endoscope 10 can be inserted into a first tube 25 of the endoscopic treatment tool 20. The endoscope 10 is a flexible endoscope having a flexible and bendable insertion section 11. The first tube 25 extends to the tip of a catheter shaft 21 and forms a first channel 23 (see Fig. 3 described below) through which the insertion section 11 of the endoscope 10 passes. The endoscopic system 1 is usually used in a state in which the tip of the insertion section 11 is inserted all the way into the tip of the catheter shaft 21 of the endoscopic treatment tool 20.
[0016] The endoscope system 1 can be applied to various endoscopic procedures, such as arthroscopes, laryngoscopes, oral endoscopes, transnasal endoscopes, biliary endoscopes, colonoscopes, and coeloscopic endoscopes. In this embodiment, the use of the endoscope system 1 in lactose catheterization is described as an example. The lactose catheterization is a treatment for chronic lower back pain caused by conditions such as spinal canal stenosis and herniated discs, in which a catheter is inserted close to the painful area to remove adhesions around nerves. Details of how the endoscope system 1 is used will be described later.
[0017] The endoscope system 1 includes a console for controlling the endoscope 10 and a monitor for displaying images acquired by the endoscope 10 (neither is shown). The console generates images by receiving electrical signals from, for example, the imaging unit 16 of the endoscope 10 (see FIG. 3 described below). The generated images are displayed on the monitor, allowing a doctor to perform a predetermined procedure while observing the inside of the body. The console also includes a light source for illumination. The console and the monitor may be integrated. The illumination device is not limited to being built into the console, and may be a device separate from the console.
[0018] The endoscope 10 constituting the endoscopic system 1 includes an insertion section 11 and a base section 2. The insertion section 11 is a section that is inserted into the body, and is inserted into the body while being inserted into a catheter shaft 21 of an endoscopic treatment tool 20. Normally, the endoscope 10 is inserted into the endoscopic treatment tool 20 so that the tip of the insertion section 11 and the tip of the catheter shaft 21 are approximately aligned. The base section 2 is a section disposed adjacent to the proximal end side of the insertion section 11, and includes a connector section 12 and a protective tube 13.
[0019] The connector portion 12 of the endoscope 10 is a portion to which a cable leading to a console is connected. A cable extending from the base end of the insertion portion 11 is connected to the connector portion 12. The cable is housed in an outer tube 15 (see FIGS. 7 and 8 described below) in the insertion portion 11 that is inserted into the endoscopic treatment tool 20, and a portion of the cable extends from the base end of the outer tube 15 and is connected to the connector portion 12. The endoscope 10 is provided with a protective tube 13 that covers the cable exposed from the outer tube 15.
[0020] The endoscopic treatment tool 20 constituting the endoscopic system 1 includes a catheter shaft 21 and a handle 22. As will be described in detail below, the catheter shaft 21 is a long, thin tube having a first channel 23 through which the endoscope 10 is inserted and a second channel 24 used for a predetermined treatment. The second channel 24 can be used to pass a medicinal solution and to insert instruments such as forceps and a brush. It is also possible to aspirate bodily fluids through the second channel 24. At least the tip portion of the catheter shaft 21 is made of a flexible material that allows it to bend.
[0021] The handle 22 of the endoscopic treatment tool 20 is the part that is gripped during use and is attached to the proximal end of the catheter shaft 21. The handle 22 is thicker than the catheter shaft 21 and has a shape that is easy to grip, and is made of, for example, a hard resin material. The handle 22 is provided with a rotation operation unit 27 for bending the distal end of the catheter shaft 21. The handle 22 also has a hand marker 33. As will be described in more detail below, the hand marker 33 serves as a mark that indicates, for example, the position of the rotation operation unit 27.
[0022] The endoscopic treatment tool 20 further includes two tubes (a first tube 25 and a second tube 26) extending from the proximal end of the handle 22. The first tube 25 constitutes the first channel 23 and is a tube into which the endoscope 10 is inserted. The second tube 26 constitutes the second channel 24 and is a tube into which instruments such as forceps and a brush are inserted. The two tubes are integrated within the handle 22 to form a single catheter shaft 21. The first tube 25 is provided with a locking portion 30 that secures the endoscope 10 and a branch port 31 for irrigation. A connector 29 is provided at the proximal end of the second tube 26.
[0023] The configuration of the endoscopic system 1, particularly the configuration of the endoscopic treatment tool 20, will be described in detail below with reference to Figures 2 to 5. Figure 2 is a perspective view of the endoscopic treatment tool 20, Figure 3 is a diagram showing the distal end surface of the catheter shaft 21, and Figure 4 is an enlarged view of the proximal end portion of the endoscopic treatment tool 20. Figure 5 is a perspective view showing a state in which a part of the handle 22 is disassembled.
[0024] 2 to 5, the endoscopic treatment tool 20 has a structure in which a catheter shaft 21 extends from the distal end of a handle 22, and two tubes extend from the proximal end of the handle 22. The catheter shaft 21 is preferably longer than the handle 22. When the endoscopic treatment tool 20 is applied to lactose catheterization, an example of a suitable length for the catheter shaft 21 is 300 mm to 400 mm. The length of the handle 22 is, for example, 60% or less of the length of the catheter shaft 21. A first tube 25 and a second tube 26 extend from the proximal end of the handle 22 by lengths shorter than the length of the handle 22.
[0025] An imaging unit 16 including an imaging element is built into the distal end of the insertion section 11 of the endoscope 10, which is inserted into the catheter shaft 21. The imaging unit 16 may include a lens, a filter, a cover glass, etc. The imaging unit 16 has, for example, a substantially square light-receiving surface, and is provided so that the light-receiving surface is located on the distal end surface of the insertion section 11. The imaging element is an element in which a large number of photodiodes that convert light into electrical signals are arranged on a substrate, and is also called a solid-state imaging element or an image sensor.
[0026] A suitable example of the imaging element is a CCD image sensor or a CMOS image sensor. Light incident on the imaging element is converted into an electrical signal, and the acquired image data is transmitted to the console. An optical fiber 18 is also disposed at the distal end surface of the insertion section 11. The optical fiber 18 is a light guide for guiding light from an illumination light source to the distal end surface of the insertion section 11. In the endoscope 10, light emitted from the optical fiber 18 is irradiated onto and reflected from a target region to be observed, and the reflected light is incident on the imaging element, thereby acquiring image data of the target region.
[0027] The catheter shaft 21 is a thin tube with a substantially constant outer diameter along its entire length. Because the catheter shaft 21 is the part that is inserted into the body, it is preferable that the outer diameter be small. The outer diameter of the catheter shaft 21 is, for example, 2.0 mm to 3.5 mm, or 2.3 mm to 3.0 mm.
[0028] As described above, the catheter shaft 21 is made of a flexible material. While the material of the catheter shaft 21 is not particularly limited, a suitable example is a polyamide-based thermoplastic elastomer (e.g., polyamidepolyamine epichlorohydrin (PAE)) that has good biocompatibility. The catheter shaft 21 may contain an X-ray contrast agent such as barium sulfate. The catheter shaft 21 may also contain various pigments to be colored.
[0029] The catheter shaft 21 may have different hardnesses at its tip portion and other portions. In this embodiment, the hardness of the tip portion of the catheter shaft 21 is lower than that of other portions, and the tip portion is configured to be bendable by operating the rotation operation unit 27. The hardness of the tip portion may be 60% or less of the hardness of the other portions. The length of the tip portion, which has a lower hardness than the other portions, is, for example, 5% to 20% of the total length of the catheter shaft 21. Making the catheter shaft 21 bendable within a predetermined length from the tip makes it easier to observe and treat the target area inside the body.
[0030] As described above, the catheter shaft 21 has a first channel 23 through which the endoscope 10 is inserted and a second channel 24 used for a predetermined treatment (see FIG. 3). The first channel 23 has a diameter that allows the endoscope 10 to be inserted therethrough and is formed over the entire length of the catheter shaft 21. The second channel 24 has a diameter that allows instruments such as forceps or a brush to be inserted therethrough and is formed parallel to the first channel 23 over the entire length of the catheter shaft 21. The catheter shaft 21 may have three or more channels, but in this embodiment, it has a double-lumen structure including two channels. The diameters of the two channels may be the same, and are, for example, 1.0 mm to 1.5 mm.
[0031] Two wires 28 are introduced into the catheter shaft 21 up to its distal end for bending the distal end by operating the rotation control unit 27 (see FIGS. 3 and 5 ). The catheter shaft 21 is manufactured by integrating two tubes that form two channels with the two wires 28, for example, by extrusion molding using a polyamide-based thermoplastic elastomer. The two tubes are a first tube 25 and a second tube 26 that extend from the proximal end of the handle 22. The proximal end of the catheter shaft 21 is located within the handle 22. That is, the two tubes and the two wires 28 are integrated within the handle 22.
[0032] At the distal end of the catheter shaft 21, a tip marker 32 is provided on part of the inner circumferential surface of the first channel 23 into which the endoscope 10 is inserted, for confirming the up-and-down orientation of the endoscope 10 (see FIG. 3 ). The endoscope 10 is inserted into the first channel 23 with its up-and-down orientation specified, and is set in the endoscopic treatment tool 20 so that the tips of the insertion section 11 and the catheter shaft 21 are aligned. However, there are cases in which it is difficult to determine the up-and-down orientation of the endoscope 10 during use. If the tip marker 32 is provided, the up-and-down orientation of the endoscope 10 can be easily confirmed in such cases. Details of how to use the tip marker 32 will be described later.
[0033] The tip marker 32 is preferably provided on the inner circumferential surface of the first channel 23 over an area that is equal to or less than half the inner circumferential length, and may be of any size that can be confirmed in images acquired by the endoscope 10. The tip marker 32 is, for example, a mark indicating the top (top) of the endoscope 10, and is provided on the upper half of the inner circumferential surface of the first channel 23. The tip marker 32 may be provided on the inner circumferential surface of the first channel 23, but in this embodiment, the tip marker 32 is provided from the inner circumferential surface of the first channel 23 to the outer circumferential surface of the catheter shaft 21 that is close to the inner circumferential surface. In this case, the position of the tip marker 32 can be easily confirmed from the outside of the catheter shaft 21.
[0034] The tip marker 32 may be provided near the tip of the catheter shaft 21 at a position away from the tip, but is preferably provided within a predetermined length range from the tip of the catheter shaft 21. The length of the tip marker 32 along the longitudinal direction of the catheter shaft 21, i.e., the above-mentioned predetermined length, is not particularly limited, but is preferably set to 0.5 mm or more because if the tip marker 32 is too small, it will be difficult to identify the marker. The length of the tip marker 32 is more preferably 1 mm or more, and is, for example, 1 mm to 5 mm or 2 mm to 4 mm. The tip marker 32 is provided, for example, only in the tip portion of the catheter shaft 21, where the hardness is reduced.
[0035] The tip marker 32 can be provided by adding a predetermined coloring material to the resin that constitutes the catheter shaft 21. The predetermined coloring material may be any material that has a color different from the pigment that colors the entire catheter shaft 21, other additives such as barium sulfate, and may be a common pigment, or resin particles, inorganic particles, or metal particles that are not commonly used as pigments. When a metal such as a platinum-iridium alloy is used as the coloring material, the position of the tip marker 32 can be easily detected under X-ray fluoroscopy. On the other hand, when a metal is used, the catheter shaft 21 tends to become hard, so it is preferable to make the size of the tip marker 32 small.
[0036] The tip marker 32 is arranged in the same direction as the upper surface of the handle 22, which will be described later, with respect to the endoscope 10 inserted into the first channel 23. In this embodiment, the endoscopic treatment tool 20 is used with the upper surface of the handle 22 facing vertically upward, and at this time, the tip marker 32, which indicates the top of the endoscope 10, also faces vertically upward. In this case, as long as the insertion section 11 of the endoscope 10 does not rotate within the first channel 23, the top and bottom of the endoscope 10 can be identified from the orientation of the upper surface of the handle 22.
[0037] The tip marker 32 can be confirmed in an image acquired by the endoscope 10. During initial setup when the endoscope 10 is inserted into the first channel 23, the top-bottom orientation of the endoscope 10 can be confirmed by the tip marker 32. Note that since the endoscope 10 is set in the endoscopic treatment tool 20 so that the tip of the insertion section 11 coincides with the tip of the catheter shaft 21, if the top-bottom orientation of the endoscope 10 becomes unclear, the endoscope 10 is moved several millimeters toward the proximal end to capture an image of the tip marker 32.
[0038] According to the endoscopic treatment tool 20, the function of the tip marker 32 makes it possible to confirm the upside-down direction of the endoscope 10 by simply moving the insertion section 11 of the endoscope 10 slightly. For example, if the tip marker 32 is located on the left side of the image displayed on the monitor, it can be seen that the top of the endoscope 10 is tilted to the left. In this case, the upside-down direction of the endoscope 10 can be readjusted by rotating the endoscope 10 so that the tip marker 32 is located on the upper side of the monitor screen. In other words, the tip marker 32 is a guide for confirming the upside-down direction of the image acquired by the endoscope 10. Note that if the tip marker 32 were not present, it would be necessary to completely withdraw the endoscope 10 from the endoscopic treatment tool 20, confirm the upside-down direction, and then reinsert it.
[0039] The handle 22 has a thickness that allows for easy gripping and is formed into a flat, cylindrical shape that is long in the direction of extension of the catheter shaft 21. The housing that constitutes the handle 22 has a rounded shape with no corners to allow for easy gripping, and the sides of the housing are gently curved so that they convex inward. In this embodiment, the up and down directions of the handle 22 are specified; for example, the side that displays the manufacturer's name, manufacturer logo, product name, etc. is the top surface of the handle 22, and the endoscopic treatment tool 20 is used with the top surface of the handle 22 facing vertically upward. As shown in Figure 5, the housing of the handle 22 includes an upper case 22a and a lower case 22b and is configured to be disassembled.
[0040] The handle 22 has a rotation control unit 27 located distally of the center in the longitudinal direction. The rotation control unit 27 is a generally disk-shaped control unit with a portion of its outer periphery protruding left and right and distally of the handle 22. A physician can bend the distal end of the catheter shaft 21 left and right by rotating the rotation control unit 27 left and right. Two wires 28 extending to the distal end of the catheter shaft 21 are fixed to the rotation control unit 27. Rotating the rotation control unit 27 left and right pulls one of the wires 28, bending the distal end of the catheter shaft 21 in the direction of rotation of the rotation control unit 27.
[0041] The convex portion 27a of the rotation operation unit 27 that protrudes in the left and right directions of the handle 22 makes it easier for fingers to hook onto it, improving operability. In addition, the convex portion 27b that protrudes toward the tip of the handle 22 serves as a marker that indicates the position of the rotation operation unit 27. When the convex portion 27b points straight toward the tip, the rotation operation unit 27 is in a neutral position, and the tip of the catheter shaft 21 is in a straight state. When the convex portion 27b points to the left or right of the handle 22, the tip of the catheter shaft 21 is bent in the direction in which the convex portion 27b points. The shape of the rotation operation unit 27 when viewed from both the top and bottom of the handle 22 is the same, and the convex portions 27b are formed on the top and bottom of the handle 22.
[0042] The rotation operation unit 27 is preferably configured to be able to maintain the orientation of the operation unit (the orientation of the convex portion 27b) even when the hand is released. In this case, the tip of the catheter shaft 21 can maintain its bent state to the left or right even when the hand is released from the rotation operation unit 27, improving operability. On the other hand, the torque of the rotation operation unit 27 is preferably set to such an extent that when the rotation operation unit 27 is turned with a finger hooked on the convex portion 27a, the rotation operation unit 27 rotates smoothly without applying excessive force.
[0043] The handle 22 has a hand marker 33 provided closer to the tip than the rotation operation unit 27. The hand marker 33 is used as a mark indicating the neutral position of the rotation operation unit 27. For example, one hand marker 33 is provided on each of the upper case 22a and the lower case 22b at a position facing each of the protrusions 27b of the rotation operation unit 27 in the neutral position. By providing the hand markers 33 on the upper and lower surfaces of the handle 22, the position of the rotation operation unit 27 can be easily confirmed even when the handle 22 is rotated. The shape and size of the hand marker 33 are not particularly limited. The hand marker 33 is, for example, a perfect circle marker with a diameter of 0.5 mm to 5 mm.
[0044] A first tube 25 extending from the proximal end of the handle 22 is provided with a locking section 30 that fixes relative movement of the endoscope 10 with respect to the catheter shaft 21. The first tube 25 is a thin tube into which the insertion section 11 of the endoscope 10 is inserted, and is connected to the catheter shaft 21 inside the handle 22 to form a first channel 23. The locking section 30 tightens and fixes the insertion section 11, preventing relative rotation of the insertion section 11 with respect to the catheter shaft 21. The locking section 30 also prevents movement of the insertion section 11 along the length of the catheter shaft 21.
[0045] The locking unit 30 is provided at or near the proximal end of the first tube 25. Because the length of the first tube 25 extending from the proximal end of the handle 22 is, for example, 100 mm or less, the locking unit 30 is located close to the proximal end of the handle 22. This allows the locking unit 30 to be easily operated. After aligning the top of the endoscope 10 with the tip marker 32, the surgeon can maintain the initial setting by fixing the insertion section 11 with the locking unit 30. Note that if the locking unit 30 is not fixed properly or the insertion section 11 is rotated with a force that exceeds the tightening torque of the locking unit 30, making it difficult to determine the top and bottom of the endoscope 10, the top and bottom orientation can be easily readjusted using the tip marker 32.
[0046] The locking unit 30 may be attached to the first tube 25 and may have any structure as long as it can fix the insertion section 11 of the endoscope 10. The locking unit 30 may be, for example, a member having a generally cylindrical shape overall, including a passage through which the insertion section 11 can be inserted, a rubber valve that opens and closes the passage, and an operating unit provided on the outer circumferential surface, and is configured to open and close the rubber valve by rotating the operating unit. The rubber valve comes into contact with the outer circumferential surface of the insertion section 11, thereby fixing the relative movement of the insertion section 11 with respect to the catheter shaft 21.
[0047] In this embodiment, since the first tube 25 is provided with a branch port 31 for irrigation, it is preferable that the locking unit 30 be provided closer to the proximal end of the first tube 25 than the branch port 31. In this case, irrigation of the endoscope 10 can be performed while the locking unit 30 maintains the state in which it tightens and fixes the insertion section 11. The locking unit 30 is disposed adjacent to the proximal end of the branch port 31, for example.
[0048] As described above, the branch port 31 is a branch path for irrigation for supplying cleaning liquid to the tip of the endoscope 10 via the first channel 23, and is attached to the first tube 25. The branch port 31 is provided between the handle 22 and the locking section 30, and forms a cleaning liquid supply port in the first channel 23 that is separate from the inlet through which the insertion section 11 of the endoscope 10 is inserted. In other words, by branching the first tube 25, cleaning liquid can be supplied via the first channel 23 with the insertion section 11 inserted into the first tube 25 and fixed by the locking section 30. The cleaning liquid is, for example, physiological saline.
[0049] The branch port 31 is formed so that the cleaning solution flows from the opening of the port toward the connecting part with the first tube 25 and gradually moves toward the distal end of the catheter shaft 21. As shown in Figure 4, the branch port 31 is preferably configured to be connectable to a needleless syringe 51 filled with cleaning solution. The cleaning solution introduced from the syringe 51 connected to the branch port 31 flows through the gap between the inner circumferential surface of the first channel 23 and the outer circumferential surface of the insertion section 11 and is supplied to the distal end surface of the insertion section 11.
[0050] The branch port 31 may be provided by attaching a member having a first path into which the insertion section 11 is inserted and a second path branched from the first path to the first tube 25. The first path forms a part of the first tube 25, and the second path becomes the branch port 31. The member that forms the branch port 31 may be fixed to the handle 22 or may be integrated with the locking section 30.
[0051] The configuration of the endoscope 10 will be described in further detail below with reference to Figures 6 to 8. Figure 6 is a plan view of the endoscope 10. Figure 7 is a longitudinal cross-sectional view of a portion of the endoscope 10 to which the protective tube 13 is attached, and Figure 8 is a cross-sectional view taken along line AA in Figure 7.
[0052] 6 to 8, the endoscope 10 has an insertion section 11 and a base section 2 including a connector section 12 and a protective tube 13, with the protective tube 13 extending from the connector section 12 to the proximal end of the insertion section 11. A cable leading to a console is connected to the connector section 12, and a cable extending from the proximal end of the insertion section 11 is also connected to the connector section 12. The cable includes an electric wire 17 that transmits an electric signal from the imaging unit 16 and an optical fiber 18 that transmits light for illumination.
[0053] The insertion section 11 has an outer tube 15 that houses electric wires 17 and optical fibers 18, and is flexible and bendable. The outer tube 15 is made of, for example, the same material as the catheter shaft 21. The electric wires 17 and optical fibers 18 are housed in the outer tube 15 in the insertion section 11 that is inserted into the endoscopic treatment tool 20, but a portion of them extends from the proximal end of the outer tube 15 and is connected to the connector section 12. The protective tube 13 covers and protects the cables extending from the outer tube 15 so that they are not exposed.
[0054] The connector portion 12 and the protective tube 13 may be grasped by the physician who is the user when inserting and setting the endoscope 10 into the endoscopic treatment tool 20, and also when using the endoscopic system 1. For example, the physician may grasp and attempt to rotate the protective tube 13 in order to change the orientation of the endoscope 10. At this time, if the locking unit 30 is not sufficiently fixed or if the endoscope 10 is rotated with a force that exceeds the tightening torque of the locking unit 30, it is conceivable that the insertion section 11 will rotate within the first channel 23, causing the top and bottom of the endoscope 10 to become unclear.
[0055] To address the above-mentioned problems, the endoscope 10 is configured such that the protective tube 13 is not fixed to the insertion section 11 or the cable, but is slidable relative to the insertion section 11. Generally, the protective tube is fixed to the insertion section using an adhesive or the like, but in this case, when a force that rotates the protective tube is applied, the insertion section rotates following the protective tube. In contrast, in the endoscope 10, the protective tube 13 rotates freely, and the insertion section 11 does not rotate following the protective tube 13. As a result, the occurrence of the above-mentioned problems is effectively suppressed.
[0056] The protective tube 13 has a tip that extends to a position overlapping the insertion section 11 so as to prevent the cable from being exposed. The protective tube 13 may be longer than the insertion section 11. The insertion section 11 has a length that exceeds the length of the endoscopic treatment tool 20. The protective tube 13 may be made of, for example, an elastomer, but any material may be used as long as it can protect the cable and has good slip properties. The protective tube 13 may be adhesively fixed to the tip of the connector section 12.
[0057] The base section 2 of the endoscope 10 preferably further includes an inner tube 14, which is a second protective tube. The inner tube 14 houses the base end of the insertion section 11, the electric wires 17, and the optical fiber 18, and is disposed within the protective tube 13. The protective tube 13 is not fixed to the inner tube 14, but is configured to be slidable relative to the inner tube 14. In other words, the protective tube 13 is configured to be slidable relative to the insertion section 11 via the inner tube 14. This effectively prevents the insertion section 11 from rotating in accordance with the protective tube 13.
[0058] The inner tube 14 is provided from the tip of the connector portion 12 to the base end of the insertion portion 11, and covers the entire length of the cable extending from the outer tube 15. Protecting the cable with two tubes ensures more reliable protection. The inner tube 14 is preferably made of an elastomer like the protective tube 13, and has excellent sliding properties relative to the protective tube 13. The length of the inner tube 14 may be substantially the same as the length of the protective tube 13.
[0059] The gap between the insertion portion 11 and the inner tube 14 is preferably sealed with adhesive 19. The adhesive 19 is filled to fill the gap and prevents water and the like from entering the insertion portion 11 and the inner tube 14. A resin with excellent water resistance is used for the adhesive 19, which can strongly bond the insertion portion 11 and the inner tube 14 together. For example, the adhesive 19 is filled from the tip of the inner tube 14 beyond the area that overlaps with the insertion portion 11. On the other hand, because the two protective tubes are not fixed with adhesive, the effect of suppressing rotation of the insertion portion 11 can be ensured.
[0060] The mechanism of the endoscope system 1 having the above configuration will be further explained below with reference to the usage mode shown in Fig. 9. Fig. 9 is a schematic diagram showing how the endoscope system 1 is used for lactose catheterization.
[0061] 9, the endoscope system 1 is used by inserting a catheter shaft 21 of an endoscopic treatment tool 20 into the body. The insertion section 11 of the endoscope 10 is inserted into a first channel 23 of the catheter shaft 21, and the insertion section 11 is fixed by a locking section 30 so as not to rotate relative to the catheter shaft 21. In the lactose catheter method, the catheter shaft 21 equipped with a sheath 50 is inserted into the body from the sacrum, and while viewing an image from the endoscope 10, the catheter shaft 21 extending from the sheath 50 is advanced along the lumbar vertebrae 70 to near the painful area.
[0062] The lactu-catheter method has attracted attention as a treatment for chronic lower back pain caused by spinal canal stenosis, herniated discs, etc., and is a method in which a catheter shaft 21 is inserted close to the painful area to remove adhesions that exist around the nerve root 71. One cause of lower back pain is inflammation of the nerve root 71, and minute adhesions exist around the inflamed nerve root 71. By removing these adhesions from around the nerve root 71, the inflammation of the nerve root 71 can be suppressed, and pain can be alleviated.
[0063] Adhesion around the nerve root 71 can be dissected and removed, for example, by supplying a medicinal solution through the second channel 24 of the catheter shaft 21. Alternatively, adhesions can be removed by inserting instruments such as forceps or a brush through the second channel 24. In either case, the prescribed procedure is performed while viewing the image from the endoscope 10. For example, the physician holds the handle 22 with his left hand to operate the catheter shaft 21, while operating instruments such as forceps or a brush with his right hand. Furthermore, as shown in FIG. 9 , the distal end of the catheter shaft 21 can be bent by turning the rotation control unit 27.
[0064] According to the endoscopic system 1, when inserting the insertion section 11 of the endoscope 10 into the first channel 23, the doctor can confirm the top-to-bottom orientation of the endoscope 10 using the tip marker 32. The doctor aligns the top of the endoscope 10 with the position of the tip marker 32 and inserts the insertion section 11 until the tip of the insertion section 11 is substantially aligned with the tip of the catheter shaft 21. The doctor then operates the locking section 30 to fix the insertion section 11.
[0065] According to the endoscope system 1, the locking unit 30 can fix the endoscope 10 in a specified up-down direction, but if the locking unit 30 is not fixed properly, for example, the insertion section 11 may rotate within the first channel 23, making it impossible to determine the up-down direction of the endoscope 10. Alternatively, a similar problem may occur if the insertion section 11 or the protective tube 13 is rotated with a force that exceeds the tightening torque of the locking unit 30.
[0066] However, in such a case, the top-bottom orientation of the endoscope 10 inserted into the first channel 23 can be easily confirmed by using the tip marker 32. If it becomes difficult to determine the top-bottom orientation of the endoscope 10, the tip marker 32 can be confirmed by moving the endoscope 10 toward the proximal end by about a few millimeters, so there is no need to pull out the insertion section 11 from the first channel 23 to confirm the top-bottom orientation, and the top-bottom orientation can be easily readjusted.
[0067] Furthermore, in the endoscope system 1, the protective tube 13 of the endoscope 10 is configured to be slidable relative to the insertion section 11, so the insertion section 11 does not rotate in accordance with the protective tube 13. A doctor may pinch and twist the protective tube 13 to change the orientation of the endoscope 10, but even when such an operation is performed, the rotation of the insertion section 11 can be effectively suppressed, and the initial setting can be maintained.
[0068] According to the endoscope system 1, when the tip of the endoscope 10 becomes soiled with body fluids or the like, cleaning liquid can be supplied to the tip of the endoscope 10 from the branch port 31 via the first channel 23. In this case, cleaning liquid is more reliably and efficiently supplied to the tip of the endoscope 10. Furthermore, because the branch port 31 is provided closer to the tip of the processing tool than the locking unit 30, irrigation can be easily performed while the endoscope 10 is fixed.
[0069] As described above, the endoscope system 1 having the above configuration is simple to operate and easy to use, and can greatly reduce the burden on the doctor who uses it.
[0070] The above embodiment can be modified as needed without impairing the object of the present invention. For example, the above embodiment illustrates the endoscopic treatment tool 20 including the locking section 30, the branch port 31, and the tip marker 32. However, it is also possible to selectively adopt at least one of these configurations, or to use a conventionally known treatment tool instead of the endoscopic treatment tool 20. However, as described above, the endoscopic system 1 including the endoscopic treatment tool 20 has excellent functionality.
[0071] In the above embodiment, the optical fiber 18 is built into the insertion section 11 of the endoscope 10, but a light source such as an LED may be disposed on the distal end surface of the insertion section 11. Also, although an endoscope equipped with an imaging element such as a CMOS image sensor has been exemplified, it is possible to use an image fiber instead of the imaging element.
[0072] 1 Endoscope system, 2 Base part, 10 Endoscope, 11 Insertion part, 12 Connector part, 13 Protective tube, 14 Inner tube, 15 Outer tube, 16 Imaging unit, 17 Electric wire, 18 Optical fiber, 19 Adhesive, 20 Endoscopic treatment tool, 21 Catheter shaft, 22 Handle, 22a Upper case, 22b Lower case, 23 First channel, 24 Second channel, 25 First tube, 26 Second tube, 27 Rotation operation part, 27a, 27b Convex part, 28 Wire, 29 Connector, 30 Lock part, 31 Branch port, 32 Tip marker, 33 Hand marker, 50 Sheath, 51 Syringe, 70 Lumbar vertebrae, 71 Nerve root
Claims
1. An endoscope comprising: an insertion section which has an outer tube that houses a cable and is inserted into the body; and a base, wherein the base has: a connector section to which the cable extending from the base end of the insertion section toward the base end is connected; and a protective tube which is provided from the connector section to the base end of the insertion section and covers the cable extending from the connector section, wherein the protective tube is not fixed to the insertion section or the cable and is configured to be slidable relative to the insertion section.
2. The endoscope according to claim 1, wherein the base portion houses the base end of the insertion portion and the cable and has a second protective tube disposed within the protective tube, the gap between the insertion portion and the second protective tube is sealed with an adhesive, and the protective tube is not fixed to the second protective tube and is configured to be slidable relative to the second protective tube.
3. An endoscopic system comprising: an endoscope as defined in claim 1 or 2; and an endoscopic treatment tool, wherein the endoscopic treatment tool comprises: a catheter shaft having a first channel through which the endoscope is inserted and a second channel used for a specified treatment; a handle attached to the base end of the catheter shaft; and a first tube constituting the first channel and extending from the base end side of the handle, wherein the first tube is provided with a locking portion for fixing the relative movement of the endoscope with respect to the catheter shaft.
Citation Information
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