1. Field of the Invention
The present invention relates to a bending tube capable of bending by operation and a medical apparatus using the bending tube.
2. Background Art
Conventionally used endoscopes provided with elongated and flexible insertion section or various medical apparatus including treatment instruments are inserted into the body cavity of a living body for conducting diagnosis or treatment.
In many cases, insertion sections of these medical apparatuses have bending sections capable of bending to permit insertion into a body cavity while following serpentine path, e.g. digestive tract or blood vessel. A commonly used medical apparatus has a transmission member (e.g. a wire) connected to the bending section and extending to an operation section having an angle knob, for example, operated by a user and connected there. The user's operation for the operation section allows the bending section to bend in predetermined directions with a predetermined bending degree.
A first aspect of the present invention is a bending tube which is provided with a bending section capable of bending and includes: a main unit having a lumen; a pair of transfer members each inserted into the bending section so that distal ends of the transfer members are connected to a distal end of the bending section or the main unit disposed distally relative to the bending section; and an operation section having proximal ends of the pair of transfer members so that the operation section is configured so that a retracting operation for retracting one of the pair of transfer members proximally causes the other one of the pair of transfer members to be linked and pushed out distally, wherein the retracting operation applies a predetermined magnitude of tension to the pair of transfer members.
A first embodiment of the present invention will be explained with reference to
The flexible and elongated insertion section 2 has an operation channel, not shown in the drawings, for inserting a treatment instrument therethrough. An arm section 3 is attached to the distal end of the insertion section 2. The arm section 3 has a channel for inserting the treatment instrument therethrough. The channel of the arm section 3 communicates with the operation channel of the aforementioned insertion section 2. An observation device 8 attached to the distal end of the insertion section 2 and movable distally and proximally in a predetermined range permits observation of, for example, a treatment site in the body cavity or of the arm section 3. It should be noted that the number of the attached arm section 3 is not specifically limited.
A pair of wires, not shown in the drawing, for operating the bending section 4, are disposed to face with each other and to place the axial line of the connected joint rings 5 therebetween. The distal end of each wire fixed to the main unit 9 connected to the most distal end of the bending section 4 extends to a proximally-provided operation section, which will be explained later, while passing through an insertion tube, not shown in the drawing, provided in each joint ring 5. In addition, the proximal end of each wire is connected to the operation section.
FG, that is obtained based on F*G, indicates a force F1 input into the distal end of this state of wire 6A wherein F indicates a force applied to the wire 6A by rotating the pulley 7 and G indicates the transfer coefficient of the wire 6A. It should be noted that the force is not transferred to the distal end of the wire 6B since the rotation of the pulley 7 provides slack to the wire 6B.
Rotating this state of pulley 7 to apply a force having magnitude F to the wire 6A similar to the case of
This state of the wire 6B having pre-tension applied thereto and linking with the rotation of the pulley 7 is pushed out distally opposite to the wire 6A while releasing the pre-tension. Therefore, H−F indicates a force acting on the wire 6B in the vicinity of the pulley 7, and H1−F1 obtained based on HG−FG, indicates a force F3 transferred to the distal end of the wire 6B.
The following is a calculation for obtaining the magnitude of torque produced by the aforementioned force and acting to bend the bending section 4 of the arm section 3.
Torque T1 produced in the conventional example shown in
Torque T2 occurred by operating the arm section 3, as shown in
That is, the bending tube according to the present invention produces bending torque substantially twice as significant as that of the conventional bending tube when a bending operation inputs the same magnitude of force into the pulley 7. Therefore, the user can conduct the bending operation with a force having substantially half the conventionally necessary magnitude.
In addition, fewer limitations associated with the configuration (e.g. the size of the operation section) can increase the design freedom for medical apparatuses adapting the bending tube since half the conventional operation degree can achieve substantially the same degree of stroke (bending range) in the arm section.
It should be noted that the magnitude H of the applied pre-tension can be set appropriately as long as the transfer member such as the wires 6A and 6B, for example, can endure the pre-tension. However, the force F1 applied to the distal end of the wire (i.e., the wire 6B in the example shown in
A second embodiment of the present invention will be explained next with reference to
A medical apparatus shown in
The bending tube of the present embodiment is a insertion section 12 having a bending section 14 attached to the distal end thereof so that the bending tube can follow a serpentine path such as digestive tract, for example, when inserted into a body cavity. The structure of the bending section 14 is basically the same as that of the bending section 4 of the first embodiment. That is, a plurality of joint rings, not shown in the drawing, are connected in the axial line direction, and a pair of wires serving as the transfer member and having an end section fixed to the main unit having the most distal joint ring connected thereto are inserted into each joint ring and extend to the operation section 13.
The proximal ends of the wires 16A and 16B are connected and fixed to the outer periphery of the pulley 17 in substantially the same form of the aforementioned arm section 3, and rotational operation to the pulley 17 can retract one of the wires 16A and 16B proximally and bend the bending section 14.
Rotating the angle knob 18 attached to the pulley 17 coaxially via the shaft 20 allows the pulley 17 to rotate.
The switching mechanism 19 is provided with: coils 21A and 21B having the wires 16A and 16B inserted therethrough respectively; a coil base 22 having end sections of the coils 21A and 21B fixed thereto; a guide 23 for guiding the movement of the coil base 22; a lever 24 subject to a user's operation; and a link 25 connecting the lever 24 to the coil base 22.
A predetermined clearance reserved between the coils 21A and 21B and the wires 16A and 16B subject to insertion respectively allows the wires 16A and 16B to freely slide in the coils 21A and 21B respectively. Each distal end of the coils 21A and 21B is fixed to the joint ring of the bending section 14, and each proximal end thereof is connected and fixed to the coil base 22.
The coil base 22 has a projection 22A. The projection 22A is inserted through an elongated hole 23A of the guide 23 attached to the shaft 20. Sliding the projection 22A along the elongated hole 23A causes the guide 23 to guide the movement of the coil base 22.
The lever 24 attached to the shaft 20 is freely rotatable, and a first end section of the link 25 attached to one of the end sections of the lever 24 is freely rotatable. A second end section of the link 25 attached to the coil base 22 is freely rotatable.
Operations in using the endoscope 11 having the aforementioned configuration will be explained.
As shown in
The user in an attempt to obtain an “on” state of the wires 16A and 16B having pre-tension applied thereto conducts rotational operation to the lever 24 in the direction indicated by an arrow B as shown in
The user, upon rendering the wires 16A and 16B to be in the “on” state, can conduct operation to the bending section 14 preferably with fewer degrees of operation to the angle knob 18, for example, similarly to the arm section 3 of the first embodiment.
The endoscope 11 according to the present embodiment having the switching mechanism 19 provided to the operation section 13 can provide preferable operation by switching pre-tension while insertion to the body cavity is subject to the “off” state and treatment is subject to the “on” state.
In addition, the shape of the bending section 14 can be fixed by applying pre-tension to the wires 16A and 16B. Accordingly, the distal end section of the insertion section 12 having the bending section 14 provided thereto, which if applied an external force, can be maintained, and the visual field of the endoscope 11 can be maintained desirably.
A third embodiment of the present invention will be explained next with reference to
A medical apparatus shown in
The bending tube of the present embodiment (i.e., the arms 33A and 33B) have first bending sections 34A and 34B having the basic structure substantially the same as that of the bending section 4 of the arm section 3 and second bending sections (fixed bending sections) 35A and 35B provided proximally relative to the first bending section respectively.
Two pairs of two wires, not shown in the drawing, are attached to the substantial cylindrical joint rings 36A of the first bending sections 34A and 34B respectively so that each pair of wires face each other to place the axial line of the joint rings 36 therebetween, and the wires are shifted by a phase of 90 degrees. Accordingly, conducting appropriate retracting operations to four wires allows the arms 33A and 33B to bend in four directions.
The second bending sections 35A and 35B are mechanisms capable of bending and fixing thereof to facilitate operation for the treatment instruments inserted through the arms 33A and 33B in a treatment which will be explained later so that the distance of the axial lines of the arms 33A and 33B increases more significantly as shown in
Operation sticks 42A and 42B subject to the user's operation are attached to the operation units 40 and 41 respectively. Each of the operation sticks 42A and 42B having the same structure has a channel for inserting the treatment instrument 100 therethrough. Each channel is connected to a forceps port 43 (see
First operation shafts 15A and 15B and second operation shafts 45A and 45B, not shown in the drawing, are, respectively attached to the operation sticks 42A and 42B, not shown in the drawing. The first operation shafts 44A and 44B make rotation linked with vertical operation by the operation sticks 42A and 42B. The second operation shafts 45A and 45B make rotation linked with horizontal operation by the operation sticks 42A and 42B. The wires extending through the link sheath 38 for operating the first bending sections 34A and 34B are attached to the first operation shafts, and to the second operation shafts of the operation units 40 and 41 respectively and detachably. A pair of the wires are connected to each first wire unit 46.
This allows the treatment instrument 100 to be inserted into the operation sticks 42A and 42B and protrude the treatment instrument 100 from the distal end of the arm section 33, thereby, moving a treatment mechanism provided to the distal end of the treatment instrument 100 vertically and horizontally by operating the operation sticks 42A and 42B vertically and horizontally for operating the arm section 33.
In addition, wires for operating the second bending sections 35A and 35B are connected to a second wire unit 47 having a structure substantially the same as that of the first wire unit 46 and attached to the operation units 40 and 41 respectively.
First retraction wires 48A and 48B for applying pre-tension to the wires connected to the first wire unit 46 extend from the first operation shaft 44A and the second operation shaft 45A respectively. A second retraction wire 49 for retracting the second wire unit 47 proximally extends from the second wire unit 47. It should be noted that the second operation unit 41, not shown in the drawings, has a similar configuration.
The wires 53A and 53B are inserted into coils 55A and 55B respectively. The distal ends of the coils 55A and 55B are fixed to the joint ring 36 of the first bending section 34A, and the proximal ends thereof are fixed to a coil base 57 attached to a base 56 of the first wire unit 46. The rotation shaft of the pulley 54 is inserted into an elongated hole 56A provided on the base 56. It should be noted that the second operation shaft 45A has a similar condition.
Operations in using the treatment endoscope 31 having the aforementioned configuration will be explained.
The user firstly inserts the insertion section 32 into a body cavity of a patient etc. The second bending section in this state of the arm section 33 is not bent and two arms 33A and 33B are set in a linear state for facilitating insertion. Also, the wire of the first bending section is in the off-state in which pre-tension is not applied thereto so that the arms 33A and 33B can bend flexibly in accordance with the shape of an organ, for example, winding in the body cavity. The distal end of the treatment endoscope 31 is moved in this way to a treatment object site.
Subsequently, the user inserts appropriately-selected treatment instruments into the operation sticks 42A and 42B and projects the distal ends thereof from the arm section 33. Subsequently, the slide lever 51 of each operation stick is operated to be attracted proximally.
This operation causes the second retraction wire 49 to be retracted proximally and causes the second wire unit 47, which is not attached to the operation shaft, to move proximally. Accordingly, the wires connected to the second wire unit 47 are retracted, and as shown in
First retraction wires 48A and 48B in this state are retracted simultaneously. Accordingly, the base 56 of the first wire unit 46 moves distally in the first operation shaft 44A and the second operation shaft 45A as indicated by an arrow shown in
The treatment endoscope 31 according to the present embodiment can achieve similar effects of the medical apparatus provided with the bending tube according to each aforementioned embodiment.
Also, since a first retraction wire for applying pre-tension to wires connected to the first bending section and a second retraction wire for bending and fixing the second bending section in a state for facilitating a treatment are connected together to the slide lever 51 provided to the operation stick, a mere retracting operation of the slide lever 51 can conduct the two operations simultaneously.
Therefore, since the second bending section which is about to be inserted into a body cavity is in a non-fixed state in the treatment endoscope 31, and since pre-tension is not applied to the first bending section, the two arms, i.e., the two bending tubes of the arm section 33 are in a freely and flexibly deformable state; therefore, insertability can be enhanced On the other hand, the second bending section is fixed in a state facilitating a treatment when the treatment is conducted, and simultaneously, pre-tension is applied to the first bending section; therefore, an easily operable state is achieved. Since the user can switch these two states easily by operating the slide lever 51, an easily operable treatment endoscope can be configured.
It should be noted that the present embodiment explained with reference to the example which adopts the bending tube of the present invention at only the arm section 33 may be replaced by a configuration in which the bending tube of the present invention is adopted in the insertion section 32 similarly to the insertion section 12 of the endoscope of the second embodiment. In this case, when a tissue retraction etc. is conducted by using a treatment instrument, for example, inserted into the arm section 33, a more desirable retraction, for example, can be conducted by applying pre-tension to the insertion section 32 and preventing deformation thereof.
Although the present invention has been described with respect to its preferred embodiments, the present invention is not limited to the embodiments described above. The configuration of the present invention allows for addition, omission, substitution and further modification without departing from the spirit and scope of the present invention.
For example, the aforementioned each embodiment explained with reference to the example in which two proximal ends of two wires are fixed to a pulley may be replaced by a configuration in which a wire is wound around a pulley and two ends thereof are fixed to a bending section respectively as long as the wire fixed to the pulley is rotatable unitarily with the pulley.
Also, another mechanism may be used in place of wires and a pulley since the effect of the present invention can be obtained if one of the wires is retracted and the other wire makes linked movement in the reverse direction. For example, the linked movement may be achieved by using a chain and a sprocket, and alternatively, a rack-and-pinion mechanism may make a linked movement of a pair of wires wherein the proximal ends of the wires are fixed to the rack.
Furthermore, the aforementioned each embodiment explained with reference to the example in which pre-tension is applied to a transfer member, e.g. a wire by moving a coil having the wire inserted therethrough in the axial line direction may be replaced by a configuration in which pre-tension is applied to a transfer member by moving an operation section (e.g. a pulley) proximally having the proximal end of a transfer member fixed thereto.
In addition, like a modified examples shown in
Therefore, the bending tube can be fixed in an arbitrary bending state, and operation can be conducted more easily. Furthermore, in a case of retraction, for example, of a tissue by using a treatment instrument inserted into the bending tube, more reliable retraction can be conducted since the deformation of the bending tube is prevented.
Also, the aforementioned each embodiment is not limited to the medical apparatus explained with reference to the example in which the medical apparatuses provided with the bending tube of the present invention are a treatment endoscope and an endoscope. Therefore, anything that conducts bending operation can be adopted to every medical apparatus including various common treatment instrument.
The present invention is not limited to the above descriptions but is limited only by the appended claims.