Body cavity interior observation device

Abstract

This invention provides a body cavity interior observation device which can be suitably applied to minimally invasive surgery and can provide a certain visual field with a simple structure. The device is characterized by including a camera member (15) and an incision retainer (10) that is attached to an incision to retain the incision in an open state, wherein: the incision retainer (10) is provided with a body front side ring member (11) and a body cavity insertion side ring member (12) disposed facing each other, and a cylindrical elastic member (13); both end parts of the cylindrical elastic member (13) are fixed to the body front side ring member (11) and the body cavity insertion side ring member (12); the body cavity insertion side ring member (12) is flexible; and the camera member (15) is provided on the body cavity insertion side ring member (12).

Description

Intracolumbar observation device

[0001] The present invention relates to an intracavity observation device.

[0002] In laparoscopic surgery, typified by robotic-assisted surgery, surgeons currently perform surgery while observing only a very narrow field of view in real time, due to the need to magnify and stereoscopically view the target organ and its surroundings within the body cavity using an endoscope (e.g., a 3D camera) attached to the robotic surgical medical device (see, for example, Patent Document 1). In this case, the entire area outside the very narrow field of view is the endoscope's "blind spot." In this blind spot, surgeons may have difficulty or even fail to notice complications such as bleeding or organ damage during surgery, making the development of a solution to this problem an important medical need. To address this issue, a multi-camera system using a trocar camera separate from the endoscope has been proposed (see, for example, Patent Document 2). However, this system has a problem in that the camera is mounted on a port, and the field of view is affected by the movement of the port.

[0003] International Publication No. 2018 / 088498 Special Publication No. 2016-506261

[0004] SUMMARY OF THE INVENTION It is therefore an object of the present invention to provide an intracavity observation device that can be suitably applied to minimally invasive surgery and that can ensure a certain field of view with a simple structure.

[0005] In order to achieve the above-mentioned object, the body cavity observation device of the present invention comprises an incision wound holder that is attached to an incision wound to hold the incision wound open, and a camera member; the incision wound holder comprises a body surface side ring member and a body cavity insertion side ring member that are arranged opposite each other, and a tubular elastic member; both ends of the tubular elastic member are fixed to the body surface side ring member and the body cavity insertion side ring member; the body cavity insertion side ring member is flexible; and the camera member is provided on the body cavity insertion side ring member.

[0006] In the body cavity observation apparatus of the present invention, it is preferable that the camera member is detachably attached to the body cavity insertion side ring member.

[0007] In the body cavity observation apparatus of the present invention, it is preferable that the camera member is attached to the body cavity insertion side ring member by a magnet.

[0008] In the body cavity observation apparatus of the present invention, it is preferable that the camera member is provided with a plurality of imaging elements for stereoscopic vision.

[0009] In the body cavity observation device of the present invention, it is preferable that the camera elements are provided in plurality, the total field of view of each camera element exceeds 360°, and the camera elements are arranged so that no gaps are created between the fields of view.

[0010] The present invention provides an intracavity observation device that can be suitably applied to minimally invasive surgery and that can ensure a certain field of view with a simple structure. In particular, the present invention enables the realization of a 360-degree intracavity monitoring system in robot-assisted surgery, thereby enabling a revolutionary improvement in the efficacy and safety of this surgery.

[0011] FIG. 1 is a perspective view of a body cavity observation device according to an embodiment of the present invention. FIG. 2 is a schematic cross-sectional view of the abdominal cavity when a body cavity observation device according to an embodiment of the present invention is attached. FIG. 3 is a view explaining the components constituting the body cavity observation device according to an embodiment. FIG. 3(A) is a view showing the camera attachment position of the incision wound holder. FIGS. 3(B) and 3(C) are views showing examples of the camera member. FIG. 4 is an explanatory view showing the state of the incision wound holder when the body cavity observation device according to an embodiment is attached to the abdominal wall. FIG. 5 is a schematic cross-sectional view of the abdominal cavity showing the observation state using a conventional endoscope.

[0012] The body cavity observation device of the present invention will be described using examples. However, the present invention is not limited to or restricted by the following examples. Note that the drawings referred to below are schematic, and the dimensional ratios of objects depicted in the drawings may differ from the dimensional ratios of actual objects. The dimensional ratios of objects may also differ between drawings.

[0013] 1 is a perspective view of a body cavity observation device according to an embodiment of the present invention. The body cavity observation device 100 of the present invention comprises an incision wound holder 10 that is attached to an incision wound to hold the incision wound open, and a camera member 15. The incision wound holder 10 comprises a body surface side ring member 11 and a body cavity insertion side ring member 12 that are arranged opposite each other, and a tubular elastic member 13, both ends of which are fixed to the body surface side ring member 11 and the body cavity insertion side ring member 12. The body cavity insertion side ring member 12 is flexible, and the camera member 15 is attached to the body cavity insertion side ring member 12.

[0014] FIG. 2 is a schematic cross-sectional view of the abdominal cavity with an intracorporeal observation device according to an embodiment of the present invention attached. FIG. 5 is a schematic cross-sectional view of the abdominal cavity showing observation using a conventional endoscope. In each figure, the fields of view of the endoscope and camera are schematically indicated by triangles. An endoscope 21 and treatment instruments 22A and 22B, such as forceps, are inserted into the abdominal cavity of a patient P through a trocar 23 and an incision wound holder 10. The trocar 23 is an insertion instrument having a pipe portion with an insertion hole passing through the interior in the axial direction, and is used as an insertion port for inserting the endoscope 21 and treatment instruments 22A and 22B into the abdominal cavity. In laparoscopic surgery, the skin of the abdominal wall P1 of the patient P is incised with a scalpel, and the trocar 23 is inserted into the abdominal cavity. In the embodiment shown in FIG. 2 , three incisions are made, with the central incision for the endoscope 21 and the incisions for the treatment instruments 22A and 22B on either side. However, this is merely an example, and the number and location of the incisions can be determined as appropriate depending on the surgical site and the number of treatment instruments to be used. The trocar 23 is inserted into the incision and attached to the abdominal wall P1. This allows the trocar 21 to be used as an insertion port for the endoscope 21 and the treatment instruments 22A and 22B. The endoscope 21 has an illumination function that emits illumination light to illuminate the body cavity, as well as an imaging function that captures images of the body cavity, with the surgical field P2 as the main imaging area. In conventional endoscopic observation, as shown in FIG. 5 , the area where the treatment instrument 22B is located (the area surrounded by the dashed line in the figure) is a blind spot for the endoscope 21, making it difficult for the surgeon to grasp the situation in areas other than the surgical field P2. If necessary, the direction of the endoscope 21 can be changed to check other areas, but during this time, the surgical field P2 becomes invisible. Also, a technique of providing a camera on the trocar 23 has been proposed, but the field of view (image capture area) moves considerably as the procedure is performed.

[0015] In the intracorporeal observation device 100 of the present invention, the intracorporeal insertion ring member 12 is fixed to the abdominal wall P1 side of the abdominal cavity. This allows fixed-point observation without being affected by the movement of the treatment instruments 22A and 22B during surgery. While robotic surgical devices already require multiple arms and other components, making it difficult to capture a wide area using separate cameras, the intracorporeal observation device 100 of the present invention allows for a fixed camera with a constant field of view located close to the abdominal wall P1. Therefore, in laparoscopic surgery, typically using surgical assistance robots, blind spots that would be present in conventional endoscopic surgery can be continuously monitored during surgery by projecting them onto a display or other device. This allows for monitoring and prevention of adverse events that may occur in such blind spots, enabling avoidance or treatment before they become serious. In particular, in telemedicine, it can be difficult to understand the surrounding situation, including the movements of the assistant. Furthermore, assistants themselves may have difficulty understanding the status (location) of the instruments they are operating. In robotic surgery, it is difficult for the robot to sense the position of the assistant's forceps. Therefore, by eliminating blind spots during surgery, any sudden movements can be detected, making it easier for medical staff, including surgeons, to give appropriate instructions.

[0016] The incision wound holder 10 constituting the intracorporeal observation device 100 of the present invention may be, for example, a medical device designed for incision wound retention, such as "Lap Disk" (registered trademark, manufactured by Hakko Co., Ltd.) or "Lap Protector" (registered trademark, manufactured by Hakko Co., Ltd.). The intracorporeal insertion ring member 12 is flexible and can restore its shape even if significantly deformed. As a result, as described below, even for small incisions, the ring shape can be significantly collapsed for insertion into and removal from the body cavity, enabling the attachment of relatively large ring members, making it useful for small-incision surgeries. Furthermore, sufficient tension is generated in the tubular elastic member 13, which provides sufficient tension to the incision wound (wound opening) and enhances the wound edge protection effect by providing adequate adhesion. For example, a superelastic alloy such as a Ti-Ni, Au-Cd, Cu-Al-Ni, Cu-Au-Zn, or Ni-Al alloy can be used for the entire ring or for the core material of the body cavity insertion ring member 12. Furthermore, a tube made of a non-toxic elastic resin such as silicone resin or vinyl chloride resin can be used for the cylindrical elastic member 13.

[0017] The camera member 15 may be provided integrally with the body cavity insertion ring member 12, but is preferably detachably attached. When the incision wound holder 10 is a disposable member, the camera member 15 may be attached to the body cavity insertion ring member 12 of the incision wound holder 10 for use. Figure 3 illustrates the components constituting the body cavity observation device according to the embodiment. Figure 3(A) illustrates the camera attachment position 14 of the incision wound holder 10, with the body cavity insertion ring member 12 facing upward to facilitate understanding of the camera attachment position 14. Figures 3(B) and 3(C) are diagrams illustrating examples of the camera member. As shown in Figure 3(A), camera attachment portions 14 may be provided at three locations on the body cavity insertion ring member 12, and a camera member 15 may be attached to each camera attachment portion. As shown in Figures 3B and 3C, attachment can be performed using a clip-like attachment device on the camera member, or by providing a magnet on the camera attachment portion 14 and attaching the camera member 15 to the magnet via magnetic force. Alternatively, a magnetically attachable metal member (such as iron, cobalt, or nickel) can be attached to the back of the camera attachment portion 14 and the camera member 15 in advance, allowing the camera attachment portion 14 and the camera member 15 to be attached by a strong magnet. Alternatively, a groove can be provided on the camera attachment portion 14, and a clip-shaped attachment member on the camera member 15 can be provided with a protrusion that can fit into the groove, allowing for easy attachment to a fixed position. The attachment device can also be provided with an adjustment unit that allows for fine adjustment of the imaging direction after attachment. However, since the intracoelom observation device 100 of the present invention is fixed to the abdominal wall P1, significant adjustment of the imaging direction is generally not required.

[0018] Although the body cavity insertion ring member 12 is flexible, it does not need to be flexible throughout (360°). A flexible portion allows it to be bent and inserted into a body cavity through a narrow incision, so the camera attachment portion 14 can be rigid. Inserting rigid portions, for example, in approximately three locations and with lengths ranging from 10 mm to 20 mm, into a body cavity is possible without any problems. For example, for a ring diameter of 70 mm, an incision (skin incision) length of 20 to 40 mm is sufficient for insertion, allowing the insertion of the body cavity insertion ring member 12 without the need for a large incision. When using the body cavity insertion ring member 12 with the camera member 15 attached, the body cavity insertion ring member 12 with the camera member 15 attached may be inserted into the body cavity and attached, or the body cavity insertion ring member 12 may be inserted into the body cavity and then the camera member 15 attached. The camera member 15 can be easily attached to the body cavity insertion ring member 12 by inserting it from the inside of the tubular elastic member 13. In particular, the use of a magnet is preferable because it makes it possible to easily attach the camera member 15 even after the body cavity insertion side ring member 12 has been installed inside the body cavity.

[0019] When the camera member 15 is connected by wire, a fiber optic cable may be threaded along the side of the cylindrical elastic member 13, ensuring a secure sealing. The wiring may also be printed. For example, the camera unit of a capsule endoscope may be used as the camera member 15, and image data may be transmitted wirelessly. If a light source is required for imaging, the light source may be built into the camera member 15, or a separate light source may be located in a location that will not interfere with surgery. Alternatively, an infrared camera that does not require a light source may be used as the camera member 15.

[0020] The camera member 15 may be provided with multiple image pickup elements to support stereoscopic vision (3D display). Using a compound camera for each of the left and right eyes enables the display of stereoscopic images, making it easier to distinguish between near and far. This configuration also makes it possible to achieve three-dimensional stereoscopic vision of areas that are blind spots in a normal endoscope.

[0021] The camera element 15 may be provided in at least one location, but may also be provided in multiple locations. Two locations are acceptable, but three locations are preferred. Having a large number of camera elements 15 facilitates troubleshooting. When multiple camera elements 15 are provided, it is preferable that the total viewing angle of each camera element 15 exceeds 360°, and that each camera element 15 be positioned so that its field of view faces outward to avoid gaps between the fields of view. For example, by providing cameras with a viewing angle of 120° or more at three locations on the ring at 120° positions and combining the images, a 360° view can be achieved. A single camera with a wide-field lens, such as a fisheye lens, may be sufficient. In this case, image processing can be performed to reduce image distortion, making the image easier to view. Furthermore, incorporating image analysis tools and applying technology to enhance visibility can enable various visualization methods, such as highlighting lesions.

[0022] FIG. 4 is an explanatory diagram showing the state of the incision holder 10 when the body cavity observation device 100 is attached to the abdominal wall P1. As shown in FIG. 4 , a portion of the body cavity insertion ring member 12 is pulled up from the inside of the tubular elastic member 13 until it protrudes about halfway from the body surface side ring member 11, resulting in a crushed state that allows insertion through a small incision. The body cavity insertion ring member 12 in its crushed, narrowed state is then slowly pushed into the incision from its lower end in the figure. Once the entire body cavity insertion ring member 12 is inserted into the body cavity, the body cavity insertion ring member 12 is attached by adhering it to the inside of the abdominal wall P1. To remove the ring member 12, a portion of the body cavity insertion ring member 12 is pulled up from the inside of the tubular elastic member 13 to the same shape, allowing it to be removed from the incision.

[0023] The body cavity observation device of the present invention is used in a body cavity observation system that allows medical staff, including doctors, to observe the inside of a body cavity (abdominal cavity) of a patient P during laparoscopic surgery. In addition to the body cavity observation device 100 of the present invention, the body cavity observation system includes an endoscope 21, a processor (not shown), a monitor, an operation terminal, and the like. The processor performs image processing on both the endoscopic images of the abdominal cavity captured by the endoscope 21 and the abdominal images captured by the camera members 15 of the body cavity observation device 100. If multiple camera members 15 are used, the processor has an image synthesis function that synthesizes the images captured by each camera member. The endoscopic image and the abdominal image are displayed on the processor monitor. These images may be a composite image. The endoscopic image and the abdominal image may be displayed in separate display windows, or alternatively or additionally, a composite image may be displayed. In this way, a view of the abdominal cavity is provided to the medical staff.

[0024] The embodiments of the present invention are not limited to the above. The arrangement and number of camera members 15 can be adjusted as appropriate depending on the camera's performance and application. Furthermore, if the incision wound holder is configured to combine an iris valve and a skirt, for example, adjusting the size of the opening allows for maintaining pneumoperitoneum even when the wire is pulled out. Furthermore, using the intracavity observation device of the present invention allows images to be acquired at fixed points, making it easy to extract differences through image processing. This is expected to facilitate trouble detection and backup using AI, etc.

[0025] 100 Body cavity observation device 10 Incision wound holder 11 Body surface side ring member 12 Body cavity insertion side ring member 13 Cylindrical elastic member 14 Camera attachment part 15, 15A, 15B Camera member 21 Endoscope 22A, 22B Treatment tool 23 Trocar P Patient P1 Abdominal wall P2 Surgical field

Claims

1. An intra-body cavity observation device comprising: an incision wound holder that is attached to an incision wound to hold the incision wound open; and a camera member; the incision wound holder comprises a body surface side ring member and a body cavity insertion side ring member arranged opposite each other; and a tubular elastic member; both ends of the tubular elastic member are fixed to the body surface side ring member and the body cavity insertion side ring member; the body cavity insertion side ring member is flexible; and the camera member is attached to the body cavity insertion side ring member.

2. The body cavity observation device according to claim 1, wherein the camera member is detachably attached to the body cavity insertion side ring member.

3. The body cavity observation device according to claim 1, wherein the camera member is attached to the body cavity insertion side ring member by a magnet.

4. The body cavity observation device according to claim 1, wherein the camera member is provided with a plurality of imaging elements for stereoscopic vision.

5. An intracavity observation device according to claim 1, comprising a plurality of camera elements, the total viewing angle of each camera element exceeding 360°, and the camera elements being arranged so that no gaps are created between the viewing angles.

Images