1. Field of the Invention
The present invention relates to an endoscope that includes an insertion portion, a treatment instrument insertion channel through which a treatment instrument is inserted, and a treatment instrument raising base that changes a protruding direction of the treatment instrument.
2. Description of the Related Art
In recent years, endoscopes have been widely used in medical fields. Some endoscopes for use in medical fields are provided with a treatment instrument insertion channel through which a treatment instrument can be inserted so that treatment such as medical attention can be performed using the treatment instrument.
For example, lateral-view endoscopes used for ERCP (Endoscopic Retrograde Cholangio-Pancreatography) include, at the distal end portion thereof, a treatment instrument raising base that changes a protruding direction of the treatment instrument.
As a conventional endoscope of this type, for example, Japanese Patent Application Laid-Open Publication No. 6-254037 discloses an endoscope cover with a channel.
The endoscope cover with a channel recited in the Japanese Patent Application Laid-Open Publication No. 6-254037 includes, on a plane surface formed on a side portion in the vicinity of a distal end of a distal end constituting portion, an observation optical system which configures an observation window and is disposed on the distal end side of the plane surface and an illumination optical system which configures an illumination window and which is disposed on both sides of the observation optical system, such that the observation optical system and the illumination optical systems align in the direction vertical to the axis direction of the insertion portion, and also includes at the rear of the observation optical system along the axis direction, a channel opening portion which communicates with a treatment instrument insertion channel provided inside the cover, and a treatment instrument raising base disposed inside the channel opening portion.
In addition, as a prior art similar to the one disclosed in the Japanese Patent Application Laid-Open Publication No. 6-254037, Japanese Patent Application Laid-Open Publication No. 63-286132 discloses a rigid endoscope in which a slope-shaped opening portion that opens on a sheath opening portion side is formed at a distal end of a distal end portion main body, a cover glass and an objective lens system which is opposed to the cover glass and set in an oblique direction such that the observation field-of-view direction has a predetermined angle with respect to the axis direction of the insertion portion are housed in the opening portion, and a treatment instrument raising device is provided at a position which is at the rear of the cover glass and the objective lens system in the axis direction of the insertion portion and which is on the side portion of the opening of the sheath.
An endoscope according to one aspect of the present invention includes: an insertion portion to be inserted in a lumen, the insertion portion including a distal end on an insertion direction side and a proximal end on an opposite side of the insertion direction; an objective optical system arranged at a distal end portion of the insertion portion and configured to obtain an image of a subject to be examined in the lumen; a treatment instrument raising base arranged on a more distal end side of the insertion portion than the objective optical system and configured to control an inclination angle of a treatment instrument inserted through the insertion portion toward the insertion direction; and a restricting portion configured to restrict an angle at which the treatment instrument directed by the treatment instrument raising base is protruded outside the insertion portion, the restricting portion being provided at the distal end portion of the insertion portion, wherein a straight line connecting the treatment instrument raising base and the objective optical system is substantially parallel to a longitudinal axis of the insertion portion, the restricting portion is provided so as to be located on a line segment connecting the treatment instrument raising base and the objective optical system when the objective optical system is viewed from right in front, and the restricting portion includes a restricting surface which contacts the treatment instrument, and when the treatment instrument raising base is maximally inclined, an angle of a central axis of the treatment instrument with respect to the longitudinal axis which is along the insertion direction of the insertion portion becomes equal to or smaller than an angle of the restricting surface with respect to the longitudinal axis.
Hereinafter, detailed description will be made on embodiments of the present invention with reference to drawings.
As shown in
The insertion portion 2 is configured by including, in the following order from the distal end, a distal end portion 5, a bending portion 6, and a flexible tube portion 7 which are provided in a linked manner.
The operation portion 3 includes a forceps port 9 disposed on a side to which the proximal end of a bend preventing portion 8 for the insertion portion 2 is connected, a grasping portion 10 as a middle portion, two bending operation knobs, i.e., an up-down bending operation knob 12a and a right-left bending operation knob 12b which are provided at the upper portion side of the grasping potion 10, a raising operation lever 13 for performing raising operation of a treatment instrument raising base 21 to be described later, an air/water feeding control button 14, a suction control button 15, and an image recording button 16.
Note that the forceps port 9 is communicated with a channel opening portion 19 through a treatment instrument insertion channel 17 disposed in the insertion portion 2 (see
Next, specific configuration of the distal end portion 5 will be described with reference to
The distal end portion 5 shown in
As shown in
The observation opening portion 20 is provided with a transparent cover glass, not shown, and inside the distal end portion 5, an observation window 25 and an illumination window 26 are disposed in this order from the distal end side along an axis O1 which is parallel to the central axis (also referred to as a longitudinal axis along which the insertion portion 2 is inserted) O of the insertion portion 2, so as to enable an observation of a site to be examined by irradiating the site to be examined with illumination light.
Detailed description will be made on the configuration of the distal end portion 5 having the treatment instrument raising base 21. As shown in
The distal end rigid portion 18 is made of a rigid resin or the like, and provided with a channel distal end space portion 19a which is communicated with the treatment instrument insertion channel 17. The distal end portion of the channel distal end space portion 19a opens outside through the channel opening portion 19. Note that the distal end portion 5 is configured such that the outer circumference from the rear end side to the proximal end side of the distal end rigid portion 18 is covered with an outer cover 29.
In addition, the distal end portion of a channel tube 22 which configures the treatment instrument insertion channel 17 is inserted in a hole which is communicated with the channel distal end space portion 19a of the distal end rigid portion 18 of the distal end portion 5. That is, the distal end portion of the channel tube 22 is connected to the distal end rigid portion 18 and communicated with the channel distal end space portion 19a provided at the distal end rigid portion 18.
The treatment instrument raising base 21 that raises a treatment instrument 30 inserted through the treatment instrument insertion channel 17 is rotatably arranged in the channel distal end space portion 19a. The treatment instrument raising base 21 is arranged so as to face the part where the treatment instrument insertion channel 17 opens, and the proximal end portion of the treatment instrument raising base is pivotally supported by a rotational axis 23 such that the treatment instrument raising base is rotationally movable in the channel distal end space portion 19a with the proximal end portion as a center. Furthermore, the treatment instrument raising base 21 is connected with a raising wire 24 for raising and falling back the treatment instrument raising base 21.
The raising wire 24 passes through a wire tube (not shown) connected to the distal end rigid portion 18, and extends to the operation portion 3 side through the inside of the insertion portion 2. The proximal end of the raising wire 24 is connected to the raising operation lever 13. Therefore, an inclination angle of the treatment instrument raising base 21 is controlled by the raising operation lever 13.
That is, with the above-described configuration, one raising wire 24 connected to the treatment instrument raising base 21 is pulled or pushed out with the raising operation lever 13 of the operation portion 3, to perform operation to advance or retract the raising wire 24 in the direction of central axis O, thereby causing the treatment instrument raising base 21 contacting the side surface of the treatment instrument 30 protruded from the channel opening portion 19 of the distal end portion 5 to rotationally move, to enable the protruding direction of the treatment instrument 30 to be changed.
Note that the treatment instrument 30 shown in
The observation window 25 of the observation opening portion 20 is arranged at the distal end portion 5 so as to be located closer to the operation portion in the longitudinal direction of the insertion portion 2 than the treatment instrument raising base 21. The observation window 18 is an optical system lens which configures a part of the objective optical system. As shown in
The solid-state image pickup device 25a is fixed to a substrate, not shown, arranged on the distal end side of an image pickup cable 27 inserted in the insertion portion 2, and electrically connected to the image pickup cable 27 through the substrate, not shown.
Note that the observation window 18 which is a part of the objective optical system has a field-of-view range 51 as shown in
As shown in
As shown in
In addition, at the distal end portion 5, the axis O1 which is a line connecting the treatment instrument raising base 21 and the observation window 25 is substantially parallel to the longitudinal axis (central axis) O which is along the insertion direction of the insertion portion 2 (see
More specifically, as shown in
In the present embodiment, the restricting surface 31A of the restricting portion 31 has a predetermined area which contacts the treatment instrument 30 and is configured to restrict the angle of the treatment instrument 30. As shown in
Note that the restricting surface 31A of the restricting portion 31 does not have to be provided integrally with the distal end rigid portion 18, but may be configured as a separated member.
The optical axis of the observation window 25 is not limited to the direction perpendicular to the longitudinal axis O, but may be inclined at a predetermined angle, that is, so as not to be parallel to the longitudinal axis O.
Description will be made on the arrangement relationship between the treatment instrument raising base 21 and the restricting surface 31A of the restricting portion 31 with reference to
In the present embodiment, as shown in
With such a configuration, as shown in
Note that, in the present embodiment, the illumination window 26 is provided such that the center of the illumination window 26 overlaps on the straight line (on the axis O1) connecting the treatment instrument raising base 21 and the observation window 25 when the illumination window 26 is viewed from right in front.
Next, description will be made on working of the restricting portion 31 of the endoscope according to the present embodiment with reference to
It is now supposed that a procedure, such as ERCP, of inserting the treatment instrument 30 into the duodenal papilla is performed by using the endoscope 1 according to the present embodiment. An operator inserts the insertion portion 2 of the endoscope 1 into the lumen of a patient, to advance the distal end portion 5 until the distal end portion reaches a position where an image of the duodenal papilla 41 of the duodenum 40 can be seen, and then places the distal end portion 5 at the position, as shown in
In this case, as is known, the bile duct 42 in the duodenal papilla 41 is located in the insertion direction of the insertion portion 2. Therefore, the operator inserts the insertion portion 2 so as to place the distal end portion 5 at a position slightly deeper side of the duodenal papilla 41 while viewing an endoscopic image.
After that, the operator brings the treatment instrument 30, which has been inserted through the forceps port 9 and the treatment instrument insertion channel 17 in the insertion portion 2, into contact with a concave portion 21a formed on the side surface of the treatment instrument raising base 21 in the channel distal end space portion 19a and advances the treatment instrument 30 until the distal end portion 30A of the treatment instrument 30 protrudes upward from the channel opening portion 19.
Then, the operator operates the raising operation lever 13 of the operation portion 3 to pull the one raising wire 24 connected to the treatment instrument raising base 21, to thereby perform operation for moving the raising wire 24 in the direction opposite to the insertion direction of the insertion portion 2. With such an operation, the treatment instrument raising base 21 which contacts the side surface of the treatment instrument 30 protruded from the channel opening portion 19 of the distal end portion 5 moves rotationally, and thereby capable of changing the protruding direction of the treatment instrument 30.
As shown in
As a result, as shown in
In contrast, in the present embodiment, the treatment instrument 30 which is directed by the treatment instrument raising base 21 to be protruded contacts the restricting surface 31A of the restricting portion 31 provided at the distal end portion 5 of the endoscope 1, and thereby the angle at which the treatment instrument is protruded outside the distal end portion 5 of the insertion portion 2 is restricted.
That is, as described above with reference to
Therefore, as shown in
Furthermore, in the present embodiment, at the distal end portion 5, the line O1 which connects the treatment instrument raising base 21 and the observation window 25 is substantially parallel to the longitudinal axis (central axis) O which is along the insertion direction of the insertion portion 2 (see
Therefore, the endoscopic image obtained when the treatment instrument 30 is directed toward the duodenal papilla 41 by using the restricting surface 31A may be the endoscopic image 50B as shown in
That is, as shown in
The configuration also enables the axis 30x in the longitudinal direction of the treatment instrument 30 to coincide with the axis (center) 42a of the bile duct 42 in the duodenal papilla 41 as a treatment target in the endoscopic image 50B.
Thus, in the endoscopic image 50B, the treatment instrument 30 is displayed from the lower direction of the screen so as not to widely overlap the duodenal papilla 41, and the axis 42a of the bile duct 42 in the duodenal papilla 41 as a treatment target coincides with the longitudinal axis 30x of the treatment instrument 30, which provides an endoscopic image with reference to which the operator can easily insert the distal end portion 30a of the treatment instrument 30 into the bile duct 42.
Therefore, the operator is easily capable of aligning the position of the distal end portion 30A of the treatment instrument 30 with the bile duct 42 as a treatment target, while viewing the endoscopic image 50B shown in
Note that description has been made on a medical procedure, such as ERCP, of inserting the treatment instrument 30 into the duodenal papilla 41 in the present embodiment. However, the present invention is not limited to such a medical procedure. For example, as shown in
In addition, since the endoscope 1 according to the present embodiment is capable of accurately aligning the treatment instrument 30 with the target part, even in the case where the treatment target in the lumen is a part covered with folds, other than the gastric angle 51, the endoscope 1 is capable of effectively performing treatment.
Therefore, the first embodiment can provide the endoscope 1 which enables treatment to be easily performed by allowing the axis of the treatment target site to coincide with the longitudinal axis of the treatment instrument 30, without obstructing the field of view of the part to be treated with the treatment instrument 30.
In addition, in the present embodiment, the illumination window 26 is arranged at a position where the center of the illumination window 26 overlaps on the straight line (central axis O) connecting the treatment instrument raising base 21 and the observation window 25 when the illumination window 26 is viewed from right in front, so as to be located on the rear side of (closer to the operation portion than) the observation window 25. With such a configuration, the light guide 28 can be inserted into the insertion portion 2 without being bent so as to avoid the treatment instrument insertion channel 17. This enables the diameters of the insertion portion 2 and the distal end portion 5 to be reduced.
Note that the restricting surface 31A of the restricting portion 31 may be a plane formed at the restricting portion which is configured as a member different from the distal end rigid portion 18, as shown in
The restricting surface 31A of the restricting portion 31 according to the present embodiment may be configured as in modified examples 1 and 2 to be described later, for example. The modified examples 1, 2 are shown in
In the first embodiment, the restricting surface 31A of the restricting portion 31 is configured by a plane. On the other hand, the restricting surface 31B according to the modified example 1 is configured by including a groove for guiding the treatment instrument 30 so as to be substantially parallel to the longitudinal axis O which is along the insertion direction of the insertion portion 2, as shown in
Note that the arc shape of the restricting surface 31B just has to be formed in accordance with the diameter of the treatment instrument 30 to be required.
In the modified example 1, the restricting surface 31B of the restricting portion 31 includes a groove and formed as the arc surface in the concave portion of the groove. On the other hand, as shown in
Therefore, the restricting portion 31 includes two restricting surfaces 31B and 31C which have different arc shapes. According to such a configuration, since the restricting portion 31 includes the restricting surface 31B and the restricting surface 31C, even when the treatment instruments 30 is used by being selected from treatment instruments having different diameters, one of the restricting surfaces contact the selected treatment instrument 30, and thereby capable of directing the protruding direction of the treatment instrument.
It is needless to say that the arc shape of each of the restricting surfaces 31B, 31C can be formed in accordance with the diameter of the treatment instrument 30 to be required. In addition, the restricting surfaces are not limited to the two restricting surfaces 31B, 31C, but grooves including two or more arc surfaces having different arc shapes may be provided respectively to configure the restricting surfaces.
Furthermore, as shown in
In addition, the illumination optical system of the endoscope 1 according to the present embodiment may be configured as described in modified examples 3, 4 to be described later, for example. The modified examples 3 and 4 are illustrated in
The illumination optical system according to the first embodiment irradiates the subject to be examined with the illumination light from the light guide 28 using the illumination window 26 as an optical member. On the other hand, the illumination optical system according to the modified example 3 includes an illumination window 26A configured by a diffusion lens and a prism lens 26B disposed under the illumination window.
The illumination light from the light guide 28 is incident on the prism lens 26B, and then reflected toward the illumination window 26A to be emitted. Since the illumination window 26A is configured by the diffusion lens, the illumination window diffuses the incident illumination light within the illumination range S3 shown in
Therefore, using the illumination optical system (illumination window 26A, prism lens 26B) according to the modified example 3 enables the subject to be examined in the field-of-view range 51 of the observation window 26 to be surely and effectively irradiated with the illumination light from the light guide 28, and the illumination optical system has much larger irradiation range S3, to enable the subject to be examined in the larger range to be irradiated with the illumination light.
The illumination optical system according to the first embodiment irradiates the subject to be examined with the illumination light from the light guide 28 using the illumination window 26 as an optical member. On the other hand, the illumination optical system according to the modified example 4 is configured by including a ring-shaped illumination window 26C formed so as to cover the outer circumference of the observation window 25.
The ring-shaped illumination window 26C includes, in the vicinity of the center thereof, a hole in which the observation window 25 is housed, and the distal end portion of the light guide 28 is arranged so as to contact the side surface of the outer circumference of the ring-shaped illumination window 26C, as shown in
The ring-shaped illumination window 26C guides the illumination light from the light guide 28, which is taken in from the side surface of the illumination window, and emits the illumination light toward the subject to be examined in the light irradiation range S4 as shown in
Therefore, using the illumination optical system (ring-shaped illumination window 26C) according to the modified example 4 is capable of irradiating the subject to be examined in the irradiation range S4 with light, with more uniform distribution of light. Furthermore, the observation window 26C can be disposed as described above, unlike the illumination window 26 provided at the rear of the observation window 25 in the first embodiment, thereby capable of reducing the length of the distal end rigid portion 18 in the longitudinal direction, which results in a size reduction of the distal end portion 5.
The illumination window 26 according to the first embodiment is arranged at a position closer to the operation portion in the longitudinal direction of the insertion portion 2 than the observation window 25. On the other hand, an illumination window 26 according to the second embodiment is arranged so as to be adjacent to an observation window 25 in the direction perpendicular to the longitudinal axis (central axis) O along which the insertion portion 2 is inserted.
That is, the illumination window 26 is arranged next to the observation window 25 in an observation opening portion 20. In addition, similarly as in the first embodiment, the illumination window 26 is connected with the light guide 28, to diffuse the illumination light from the light guide 28 within a predetermined irradiation range and emit the illumination light. Note that the illumination window 26 may be configured by using an optical member similar to the one used in the first embodiment, but it is desirable to configure the illumination window 26 by using an optical member such as a diffusion lens having a larger irradiation range than that of the optical member used in the first embodiment.
Other configurations and workings are the same as those in the first embodiment.
Therefore, with the second embodiment, it is possible to obtain the same effects as those in the first embodiment. In addition, arranging the illumination window 26 adjacent to the observation window 25 in the direction perpendicular to the longitudinal axis (central axis) O along which the insertion portion 2 is inserted enables reduction in length in the longitudinal direction of the distal end constituting portion 18 and in the size of the distal end portion 5.
Note that, in the first and second embodiments, description has been made on the configuration in which the illumination light from the light guide 28 is emitted using the illumination window 26, as means for obtaining illumination light, but the present invention is not limited to the configuration. For example, illumination light with which the subject to be examined may be obtained through the illumination window 26, by providing a light emitter such as an LED under the illumination window 26, connecting a driving signal line to the light emitter, and supplying a driving signal to the light emitter through the driving signal line.
In addition, when the endoscope 1 according to the first and second embodiments is connected to a predetermined video processor, marks showing the distal end position of the treatment instrument 30 according to the raised state of the treatment instrument raising base 21, the insertion direction and insertion distance of the treatment instrument 30, and the like may be displayed on the screen.
The present invention is not limited to the above-described first and second embodiments and the modified examples 1 to 4, and various changes and modifications are possible without departing from the gist of the present invention.
Number | Date | Country | Kind |
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2013-047117 | Mar 2013 | JP | national |
This application is a continuation application of PCT/JP2013/081505 filed on Nov. 22, 2013 and claims benefit of Japanese Application No. 2013-047117 filed in Japan on Mar. 8, 2013, the entire contents of which are incorporated herein by this reference.
Number | Date | Country | |
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Parent | PCT/JP2013/081505 | Nov 2013 | US |
Child | 14459645 | US |