The present disclosure relates to an endoscope.
Conventionally, an invention relating to a flexible channel for an endoscope having excellent resistance to autoclave sterilization is known (see Patent Literature 1). The flexible channel for an endoscope described in Patent Literature 1 includes a spiral tube, a reticular tube that covers the spiral tube, and an outer cover that covers the outer periphery of the reticular tube. In this flexible channel for an endoscope, at least the outer surface of the outer cover contains a thermoplastic elastomer containing 0.5 to 50% by weight of a fullerene compound (see claim 1 in the same document).
Patent Literature 1: JP 2006-116128 A
The insertion portion of the endoscope using the flexible channel for an endoscope described in Patent Literature 1, various built-in objects such as an air supply tube, a water supply tube, an angle wire, a cable, an optical fiber, and so on are accommodated inside the flexible channel for an endoscope in which the spiral tube, the reticular tube, and the outer cover are layered.
The insertion portion has a complicated configuration because components or an adhesive agent for assembling the flexible channel for an endoscope and each built-in object is also required. Therefore, the assembly is time-consuming and expensive, and reprocessing such as cleaning after use is time-consuming.
According to one aspect, it is an object to provide an endoscope having an insertion portion with a simple configuration.
An endoscope includes an insertion portion, and an operation unit that is connected to one end of the insertion portion. The insertion portion includes a tube that is provided with a plurality of channels penetrating in a longitudinal direction, an operation unit that is connected to one end of the tube, and a distal tip that covers another end of the tube and has a through hole that smoothly communicates with a part of the plurality of channels.
According to one aspect, it is possible to provide an endoscope having an insertion portion with a simple configuration.
Hereinafter, embodiments of the present disclosure will be described with reference to drawings. In the accompanying drawings, functionally identical elements may be represented by the same number. In the following description, “axial direction” indicates the axial direction of the insertion portion of the endoscope, “front side” indicates a subject side, and “rear side” indicates an operation unit side of the endoscope.
<Configuration of Endoscope System>
The endoscope system 1 of this embodiment includes, for example, a monitor 2, a processor 3, and an endoscope 100.
The endoscope 100 includes an insertion portion 110 that is inserted into a subject and an operation unit 130 that bends a part of the insertion portion 110. Although the details will be described later, in the endoscope 100 of this embodiment, at least a part of the insertion portion 110 is configured by a resin tube 110a. Further, the tube 110a has a plurality of resin channels 110b which form the tube 110a.
More specifically, the insertion portion 110 includes, for example, a distal tip 111 including an imaging unit 120, a bending section 112 that is bent by the operation unit 130, and a soft portion 113 between the bending section 112 and the operation unit 130. Then, at least a part of the bending section 112 and the soft portion 113 is configured by the tube 110a. The Shore A hardness of the resin forming the tube 110a is, for example, in a range of A30 or more and A95 or less in the case of polyurethane (urethane rubber), where a first portion is A30 and a second portion is A90. In this way, a plurality of different hardness can be adopted by changing the mixing ratio of materials.
A plurality of channels 110b of the tube 110a forming the insertion portion 110 of the endoscope 100 include, for example, a cable channel 36 (see
Further, although not illustrated, the endoscope 100 includes, for example, a rigid member that is inserted into the channel 110b of the tube 110a that forms the insertion portion 110, and an angle wire 41 (see
The endoscope 100 also includes a connector cable 140 extending from the operation unit 130 and a connector unit 150 provided at an end portion of the connector cable 140. The connector unit 150 is connected to the processor 3. The processor 3 is a device for processing image data input from the endoscope 100 and generating a video signal. The monitor 2 is connected to the processor 3. The monitor 2 displays the internal image of the subject, which is captured by the endoscope 100 and generated by the processor 3.
<Endoscope>
As described above, the endoscope 100 includes the insertion portion 110 and the operation unit 130 that bends a part of the insertion portion 110. The insertion portion 110 includes, for example, the distal tip 111 including the imaging unit 120, the bending section 112 that is bent by the operation unit 130, and the soft portion 113 between the bending section 112 and the operation unit 130.
In the endoscope 100 of this embodiment, as described above, at least a part of the insertion portion 110 is configured by the resin tube 110a having the plurality of channels 110b, for example, a multi-lumen tube having pliability and flexibility. More specifically, at least a part of the bending section 112 and the soft portion 113 is configured by the resin tube 110a having the plurality of channels 110b, and the Shore A hardness of the resin constituting the tube 110a is, for example, A30 or more and A95 or less.
The Shore A hardness of the resin of the bending section 112 may be lower than the Shore A hardness of the resin of the soft portion 113, for example. Further, the length of the bending section 112 and the length of the insertion portion 110 including the bending section 112 and the soft portion 113 can be set to a length according to the application of the endoscope 100. For example, in the case of the upper digestive tract, the length of the bending section 112 and the length of the insertion portion 110 are about 40 mm to 60 mm and about 1000 mm to 1100 mm, respectively. In the case of the large intestine, the length of the bending section 112 and the length of the insertion portion 110 are about 80 mm to 100 mm and about 1100 mm to 1700 mm, respectively. In the case of the duodenum, the length of the bending section 112 and the length of the insertion portion 110 are about 30 mm to 40 mm and 1200 mm to 1300 mm, respectively.
In the example illustrated in
In addition, the endoscope 100 of this embodiment is, for example, a single-use endoscope including a single-use portion S and a reusable portion R. The single-use portion S includes, for example, the tube 110a that forms at least a part of the insertion portion 110, and is replaced each time the endoscope 100 is used. The reusable portion R includes, for example, the imaging unit 120, is collected for each single use of the endoscope 100, is cleaned and sterilized, and is reused.
The single-use portion S may be only the tube 110a forming the insertion portion 110, but may be the entire insertion portion 110 including the tube 110a, or may be a part of the insertion portion 110 including the tube 110a. Further, the single-use portion S may include the operation unit 130, the connector cable 140, and the connector unit 150. Further, the bending section 112 may be configured by the one tube 110a integrally with the soft portion 113, but may be configured by the tube 110a forming the soft portion 113 and another tube 110a. Each part of the single-use portion S is preferably made of resin as much as possible from the viewpoint of cost reduction.
The reusable portion R may be only the imaging unit 120, but may also include a part of the insertion portion 110 excluding the tube 110a. For example, the reusable portion R may include the bending section 112. In addition, the reusable portion R may include a part or all of the operation unit 130, the connector cable 140, and the connector unit 150.
The resin forming the tube 110a may be a non-porous resin as a whole, that is, a solid resin that is not a porous resin, or at least a part thereof may be a porous resin. The tube 110a can be manufactured by extrusion molding of a resin material, for example.
As a resin forming the tube 110a, for example, PTFE (Polytetrafluoroethylene), ePTFE (expanded PTFE), PE (Polyethylene), HDPE (High Density Polyethylene), PP (Polypropylene), or the like can be used. As a non-porous resin forming the tube 110a, for example, PU (Polyurethane), PP (Polypropylene), PE (Polyethylene), Polyamide (Polyamide), or the like can be used.
The Shore A hardness of the resin forming the tube 110a can be in a range of A30 to A95, for example. The Shore A hardness of the resin can be adjusted within the above range by changing the mixing ratio of the materials. For example, the mixing ratio of the resin material forming the tube 110a may be changed in the vicinity of the boundary between the bending section 112 and the soft portion 113, so that the Shore A hardness of the bending section 112 and the Shore A hardness of the soft portion 113 can be made different.
More specifically, the Shore A hardness of the resin in the bending section 112 can be, for example, the softest A30. The Shore A hardness of the resin in the soft portion 113 is higher than the Shore A hardness of the resin in the bending section 112, for example, in a range of A40 or more and A70 or less, or a range of A45 or more and A70 or less. Further, the Shore A hardness of the resin in the soft portion 113 can be set according to the outer diameter of the tube 110a forming the soft portion 113, for example, as illustrated in Table 1 below. Here, the material of the resin is PU. Thereby, the pliability and flexibility of the bending section 112 can be improved, and the bending section 112 can have flexural rigidity suitable for bending operation.
The tube 110a forming the insertion portion 110 may be in a state of being constantly compressed in the axial direction between the imaging unit 120 and the operation unit 130, for example. As a result, the density of the tubes 110a can be improved, and the flexural rigidity of the insertion portion 110 can be improved.
Further, in the tube 110a forming the insertion portion 110, the Shore A hardness of the resin may change in the axial direction or the radial direction of the tube 110a. For example, in the tube 110a forming the insertion portion 110, the Shore A hardness of the resin may change in the radial direction of the tube 110a. More specifically, the Shore A hardness of the outer surface of the tube 110a may be higher than the Shore A hardness of the center of the tube 110a in the radial direction of the tube 110a.
Further, in the radial direction of the tube 110a, the Shore A hardness may be reduced continuously or stepwise from the center toward the outer surface. In addition, in the radial direction of the tube 110a, the Shore A hardness may be reduced continuously or stepwise from the outer surface toward the center. The stepwise change in Shore A hardness includes a discontinuous change in Shore A hardness. Here, the discontinuous change in Shore A hardness includes that a portion having a constant Shore A hardness is between the portions having a changing Shore A hardness, or that the Shore A hardness changes stepwise.
Further, the tube 110a may have a non-porous resin layer having a porosity of 0% on the outer surface on the radially outer side and a portion in the vicinity thereof. Thereby, it is possible to prevent the liquid from permeating from the outer surface of the insertion portion 110. Further, the tube 110a may have a non-porous resin layer having a porosity of 0% on the inner wall surface of the channel 110b and a portion in the vicinity thereof. Thereby, it is possible to prevent the liquid from permeating from the inner wall surface of the channel 110b of the insertion portion 110.
Further, the Shore A hardness of the resin forming the tube 110a is continuously or stepwise changed in the axial direction of the tube 110a from the end portion on the operation unit 130 side, which is the proximal end of the insertion portion 110, toward the distal tip 111 of the insertion portion 110. For example, as described above, the Shore A hardness of the resin of the bending section 112 may be lower than the Shore A hardness of the resin of the soft portion 113 in the axial direction of the tube 110a.
The stepwise change in Shore A hardness in the axial direction includes a discontinuous change in Shore A hardness, as in the case of the radial direction. Here, the discontinuous change in Shore A hardness includes that a portion having a constant Shore A hardness is between the portions having a changing Shore A hardness, or that the Shore A hardness changes stepwise. Further, the material of the tube 110a in the portion of the insertion portion 110 connected to the operation unit 130 may be, for example, a non-porous resin having a porosity of 0%.
In the example illustrated in
Further, as described above, when the guide tube for inserting the angle wire 41 is inserted into the channel 110b of the tube 110a forming the insertion portion 110, the guide tube may have higher flexural rigidity than the tube 110a. In this case, the guide tube may be inserted into the channel 110b of the tube 110a on the proximal end side of the insertion portion 110 rather than the bending section 112, that is, on the operation unit 130 side rather than the bending section 112.
In the example illustrated in
As the guide tube, for example, a hard tube made of fluororesin (PTFE, FPA, FEP, etc.) or polyimide can be used. In addition to the guide tube, a rigid member having higher flexural rigidity than the tube 110a may be inserted into the channel 110b of the tube 110a for the purpose of improving the flexural rigidity of the tube 110a. As a rigid member, for example, a close contact coil (stay coil) made of metal such as a spring stainless material (SUS304-WPB) can be used. Such a hard tube or a metal contact coil can be inserted into the channel 110b for inserting the angle wire 41 of the tube 110a over the entire length of the soft portion 113.
In the example illustrated in
In the example illustrated in
In the example illustrated in
The soft portion 113 of the endoscope 100 is required to transmit the operation at hand to the distal tip of the insertion portion 110. Specifically, it is important that an operation at hand, such as twisting or pushing and pulling, is directly transmitted to the distal tip of the insertion portion 110 in a state where the soft portion 113 is looped in the large intestine. Further, it is also important that a repulsive force from a mucous membrane at the distal tip of the insertion portion 110 is transmitted to the fingers of the operator who grips the soft portion 113 when inserting the insertion portion 110 into the subject, from the viewpoint of preventing perforation and the like.
Further, in the case of the endoscope 100 for the large intestine, it is difficult to insert the insertion portion 110 into the sigmoid colon, the spleen curve, and the liver curve. Therefore, for example, the length of the pliable portion is set to about 400 mm, and the Shore A hardness of the resin forming the tube 110a is changed stepwise according to the outer diameter as described above, whereby the insertion into the sigmoid colon, spleen curve, and liver curve becomes easy. Moreover, the operation at hand is easily transmitted to the distal tip, and the repulsive force from the subject is easily transmitted to the operator's finger. The Shore A hardness of the hard portion may be continuously increased toward the operation unit 130 side.
In the example illustrated in
In the example illustrated in
Next, in the middle of the two pairs of rollers W1 and W2 in the axial direction of the tube 110a, a measuring rod L of a measuring instrument M in the radial direction of the tube 110a presses a roller W3 arranged on one side in the radial direction of the tube 110a by a predetermined amount D1 of indentation in the radial direction of the tube 110a, and the tube 110a supported between the two pairs of rollers W1 and W2 is bent. In this state, the reaction force acting on the measuring rod L is measured by the measuring instrument M, and this reaction force is used as the flexural rigidity of each tube 110a or the insertion portion 110. For example, when the outer diameter of the tube 110a is φ8 mm, the distance D2 between the rollers W1 separated in the axial direction of the tube 110a can be set to 200 mm and the amount D1 of indentation can be set to 20 mm.
As illustrated in
The insertion portion 110 also includes a contact-type power source connector 110c and a signal connector 110d at the distal tip of the tube 110a. The power source connector 110c is connected to the power source terminal of the connector unit 150, for example, via a power source cable passed through the cable channel 36 of the tube 110a. The signal connector 110d is connected to the signal terminal of the connector unit 150, for example, via a signal cable that passes through the cable channel 36 of the tube 110a that forms the insertion portion 110.
The imaging unit 120 includes, for example, a cylindrical body portion 121, a forceps port 121a provided in the body portion 121, an air supply port 121b, a water supply port 121c, and an auxiliary water supply port 121d. The forceps port 121a, the air supply port 121b, the water supply port 121c, and the auxiliary water supply port 121d are openings of the treatment tool channel, the air supply channel, the water supply channel, and the auxiliary water supply channel provided in the body portion 121, respectively, and communicate with the treatment tool channel 31, the air supply channel 32, the water supply channel 33, and the auxiliary water supply channel 34 provided in the tube 110a via the openings 112a, 112b, 112c, and 112d of the tube 110a. Further, the imaging unit 120 has a power source pin 122 and a signal pin 123 at the rear end of the body portion 121 connected to the distal tip of the tube 110a.
The joint between the imaging unit 120 and the insertion portion 110 is covered with a fractured portion 114 of a tube shape. As a material of the fractured portion 114, for example, a resin having pliability and flexibility can be used, as with the tube 110a forming the insertion portion 110. The fractured portion 114 covers not only the joint between the imaging unit 120 and the insertion portion 110 but also, for example, the rear end of the imaging unit 120 adjacent to the joint and the distal tip of the bending section 112. The fractured portion 114 is, for example, adhered or joined to the rear end of the imaging unit 120 and the distal tip of the bending section 112, and is broken when the imaging unit 120 forming the distal tip 111 of the insertion portion 110 is removed from the insertion portion 110.
The power source pin 122 is connected to, for example, the image sensor 124 and the small LED illumination 127. By inserting and connecting the power source pin 122 into the power source connector 110c at the distal tip of the tube 110a, it becomes possible to supply power to the image sensor 124 and the small LED illumination 127. The signal pin 123 is connected to, for example, the image sensor 124 and the small LED illumination 127. By inserting and connecting the signal pin 123 into the signal connector 110d at the distal tip of the tube 110a, the image signal of the image sensor 124 can be output to the signal terminal of the connector unit 150 via the signal cable. Note that the connection for outputting the image signal of the image sensor 124 is not limited to the contact type using the pins and the connector, and may be changed to a wireless type connection such as Bluetooth (registered trademark), for example.
The body portion 121 is made of, for example, a hard resin different from the pliable resin that forms the tube 110a. The body portion 121 may be partially or wholly transparent, for example. In this case, lenses such as the objective lens 125 and the illumination lens 126 may be integrally formed with the body portion 121. When the imaging unit 120 is configured by the image sensor 124 alone, the imaging unit 120 does not need to include the main body portion 121. In this case, the imaging unit 120 is configured by the image sensor 124 sealed with resin or the like, and can be arranged so as to be embedded at the distal tip of the tube 110a that forms the distal tip 111 of the insertion portion 110.
Hereinafter, the operation of the endoscope 100 of this embodiment will be described.
As described above, the endoscope 100 of this embodiment includes the insertion portion 110 including the imaging unit 120, and the operation unit 130 that bends a part of the insertion portion 110. Then, at least a part of the insertion portion 110 is configured by a resin tube 110a. Further, the tube 110a has a plurality of resin channels 110b which form the tube 110a.
As described above, by configuring at least a part of the insertion portion 110 of the endoscope 100 with the resin tube 110a, the insertion portion 110 may have the pliability, flexibility, and smoothness of the outer surface of the tube 110a. Therefore, it is possible to prevent deterioration of operability and insertability when the insertion portion 110 is inserted into the body of a patient. Further, the tube 110a has the plurality of resin channels 110b forming the tube 110a itself, that is, the resin tube 110a having the plurality of channels 110b, for example, a multi-lumen tube. As a result, the insertion portion 110 can be easily manufactured with a relatively inexpensive material, and the cost of the endoscope 100 can be reduced.
Further, the endoscope 100 of this embodiment includes the insertion portion 110 and the operation unit 130 that bends a part of the insertion portion 110, as described above. The insertion portion 110 includes the distal tip 111 including the imaging unit 120, the bending section 112 that is bent by the operation unit 130, and the soft portion 113 between the bending section 112 and the operation unit 130. Further, at least a part of the bending section 112 and the soft portion 113 is configured by the resin tube 110a having the plurality of channels 110b. The Shore A hardness of the resin forming the tube 110a is A30 or more and A95 or less.
As described above, by configuring at least a part of the bending section 112 and the soft portion 113 by the resin tube 110a, the insertion portion 110 may have the pliability, flexibility, and smoothness of the outer surface of the tube 110a. Therefore, it is possible to prevent deterioration in operability and insertability when the bending section 112 and the soft portion 113 are inserted into the patient's body. Further, since the Shore A hardness of the resin forming the tube 110a is A30 or more and A95 or less, the flexural rigidity corresponding to the Shore A hardness of the tube 110a can be imparted to the bending section 112 and the soft portion 113.
For example, when the Shore A hardness of the resin of the bending section 112 is lower than the Shore A hardness of the resin of the soft portion 113, the flexural rigidity of the tube 110a in the bending section 112 can be lowered than the flexural rigidity of the tube 110a in the soft portion 113. As a result, the operation of bending the bending section 112 is facilitated, and the operability of the endoscope 100 can be further improved.
Further, the endoscope 100 of this embodiment includes the single-use portion S including a tube 110a that is replaced for each use, and the reusable portion R including the imaging unit 120 that is collected and reused for each use. As a result, the single-use portion S including the relatively inexpensive tube 110a can be made disposable, and an endoscopic examination can be performed while always maintaining a high level of cleanliness.
Further, by replacing the single-use portion S including the tube 110a with a new one after each use and disposing of the single-use portion S, it is possible to save the labor such as cleaning, sterilization, and sanitization of the insertion portion 110. The risk of temporal damage and failure of the insertion portion 110 can be reduced. In addition, the reusable portion R including the relatively expensive imaging unit 120 is recovered for each use, washed, sterilized, and sanitized to be reused, so that the maintenance cost of the single-use endoscope 100 in which the parts other than the reusable portion R are disposable can be reduced.
In addition, in the endoscope 100 of this embodiment, the insertion portion 110 includes the fractured portion 114 that is fractured when the imaging unit 120 is removed. Thus, for example, after the use of the endoscope 100, if a third party who does not have the authority to exchange the single-use portion S removes the imaging unit 120, the fractured portion 114 breaks and the endoscope 100 becomes impossible to be reconfigured. Therefore, it is possible to prevent the reuse of the single-use portion S including the tube 110a and the unauthorized removal of the imaging unit 120. Therefore, it is possible to improve the traceability of the endoscope 100 and further improve the safety and reliability.
Note that, as described above, when the imaging unit 120 is embedded in the distal tip of the tube 110a forming the distal tip 111 of the insertion portion 110, the tube 110a serves as the fractured portion 114. That is, in order to collect the reusable portion R including the imaging unit 120, it is necessary to break the tube 110a and take out the imaging unit 120 in the tube 110a.
Thus, after the use of the endoscope 100, if a third party who does not have the authority to exchange the single-use portion S removes the imaging unit 120, the tube 110a is broken and the endoscope 100 becomes impossible to be reconfigured. Therefore, it is possible to prevent the reuse of the single-use portion S including the tube 110a and the unauthorized removal of the imaging unit 120. Therefore, it is possible to improve the traceability of the endoscope 100 and further improve the safety and reliability.
Therefore, according to the endoscope 100 of this embodiment, removal of the imaging unit 120 by an unauthorized third party can be prevented by the fractured portion 114 or the tube 110a. Even if the imaging unit 120 is removed, the fractured portion 114 or the tube 110a is broken, so that it is possible to easily determine that the imaging unit 120 has been removed.
On the other hand, when the authorized administrator who manages the endoscope 100 collects the reusable portion R including the imaging unit 120, the fractured portion 114 or the tube 110a is broken, and the imaging unit 120 and the small LED illumination 127 can be easily taken out. Then, the reusable portion R including the taken-out imaging unit 120 can be washed and sterilized, and these can be reused.
The image sensor 124 and the small LED illumination 127 of the imaging unit 120 have the same performance as the image sensor and the small LED illumination used in the imaging unit of a normal reuse endoscope. Since the imaging unit 120 including such a high-performance image sensor 124 and the small LED illumination 127 is expensive, after the used endoscope 100 is collected from the user, it is removed by the administrator of the endoscope 100, washed, sterilized, sanitized, and supplied for reuse.
The inexpensive single-use portion S including the tube 110a is discarded and incinerated, for example. The resin forming the single-use portion S may be reused as a raw material after being dissolved, for example. That is, a new endoscope 100 is manufactured by the reusable portion R including the cleaned, sterilized, and sanitized imaging unit 120 and the single-use portion S including the completely new tube 110a, and is supplied to the user again.
Further, when at least a part of the tube 110a is made of a porous resin, the pliability and flexibility of the porous resin portion can be improved more than the pliability and flexibility of the non-porous portion which is not made of porous resin. Therefore, the operability and insertability of the insertion portion 110 can be improved.
Further, as described above, the Shore A hardness of the resin may change in the axial direction or the radial direction of the tube 110a. As the Shore A hardness of the resin decreases, the pliability and flexibility of the resin improve. On the other hand, when the Shore A hardness of the resin increases, the pliability and flexibility of the resin decrease.
Therefore, for example, the pliability and flexibility can be changed by changing the Shore A hardness of the resin forming the tube 110a in the axial direction, that is, the longitudinal direction of the insertion portion 110. Further, the pliability and flexibility of the insertion portion 110 can be improved by changing the Shore A hardness of the resin forming the tube 110a in the radial direction of the insertion portion 110.
Specifically, for example, the Shore A hardness of the resin forming the tube 110a can be increased from the radially inner side to the outer side of the insertion portion 110, or the Shore A hardness of the resin forming the tube 110a can be increased from the radially outer side to the inner side of the insertion portion 110.
Further, the endoscope 100 of this embodiment includes, as described above, the rigid member inserted into the channel 110b of the tube 110a, and the angle wire 41 which is inserted into the rigid member and connected to the bending mechanism of the bending section 112. Then, the operation unit 130 is provided so that the angle wire 41 can be operated. Accordingly, the angle wire 41 can be operated by the operation unit 130, and the bending mechanism can be bent by the angle wire 41. Therefore, the bending section 112 can be freely bent by operating the operation unit 130.
Further, the rigid member inserted into the channel 110b of the tube 110a has, for example, a higher flexural rigidity than the tube 110a, and is inserted into the channel 110b in the soft portion 113 on the proximal end side rather than the bending section 112. With this rigid member, the channel 110b can be protected by the soft portion 113 on the proximal end side rather than the bending section 112, and the channel 110b can be prevented from being damaged by the guide wire. Further, the flexural rigidity of the soft portion 113 can be improved by the rigid member inserted into the channel 110b of the tube 110a, and the operability and insertability when inserting the insertion portion 110 into the patient's body can be improved.
As described above, according to this embodiment, it is possible to provide the endoscope 100 and the endoscope system 1 capable of suppressing the cost without deteriorating the operability and the insertability.
<First Modification of Endoscope>
<Second Modification of Endoscope>
<Third Modification of Endoscope>
<Fourth Modification of Endoscope>
<Fifth Modification of Endoscope>
This embodiment relates to the endoscope 100 in which the flexural rigidity changes at a rigidity changing position P1 provided at one position on the way of the soft portion 113. Descriptions regarding common parts with the first embodiment will be omitted.
As described above, the insertion portion 110 includes the resin tube 110a. The tube 110a is a multi-lumen tube provided with a plurality of through holes penetrating in the longitudinal direction. One end of the tube 110a is covered with the distal tip 111. The other end of the tube 110a is attached to the inside of the operation unit body 131 through a folding portion 135.
In the following description, the distance from the distal tip of the insertion portion 110 to the boundary between the distal tip 111 and the bending section 112 is referred to as a distance L0. Similarly, the distance from the distal tip of the insertion portion 110 to the boundary between the bending section 112 and the soft portion 113 is referred to as a distance L1. The distance from the distal tip of the insertion portion 110 to the rigidity changing position P1 where the flexural rigidity of the insertion portion 110 changes is referred to as L2. The distance from the distal tip of the insertion portion 110 to the distal tip of the folding portion 135, that is, the effective length of the endoscope 100 is referred to as Leff.
The forceps port 121a, the air supply port 121b, the water supply port 121c, the auxiliary water supply port 121d, an observation window 24, and two illumination windows 27 are arranged at the distal tip 111. The observation window 24 is arranged between the two illumination windows 27. The imaging unit 120 including the image sensor 124 is arranged on the back side of the observation window 24. The small LED illumination 127 is arranged on the back side of the illumination window 27.
The forceps port 121a, the air supply port 121b, the water supply port 121c, and the auxiliary water supply port 121d are through holes provided at the distal tip 111. The air supply port 121b, the water supply port 121c, and the auxiliary water supply port 121d are arranged around the forceps port 121a. The air supply port 121b and the water supply port 121c may be provided with nozzles that direct the jetted water and air toward the observation window 24 side.
A holding block 110e that holds two power source connectors 110c and two signal connectors 110d is embedded closer to the central axis side of the tube 110a than the upper retaining portion 411 in
Four openings from the opening 112a to the opening 112d are arranged on the end surface of the bending section 112. The opening 112a is provided at a position corresponding to the forceps port 121a, and has an inner diameter substantially equal to that of the forceps port 121a. The opening 112b is provided at a position corresponding to the air supply port 121b, and has an inner diameter substantially equal to that of the air supply port 121b.
The opening 112c is provided at a position corresponding to the water supply port 121c, and has an inner diameter substantially equal to that of the water supply port 121c. The opening 112d is provided at a position corresponding to the auxiliary water supply port 121d, and has an inner diameter substantially equal to that of the auxiliary water supply port 121d.
The distal tip 111 is arranged on the end surface of the tube 110a. The signal pin 123 protruding from the distal tip 111 is inserted into the signal connector 110d held by the holding block 110e. Similarly, the power source pin 122 is inserted into the power source connector 110c. The power source pin 122 and the power source connector 110c, and the signal pin 123 and the signal connector 110d are held by contacts (not illustrated) so as to be electrically connected and at the same time not to be easily removed.
The joint between the tube 110a and the distal tip 111 is covered by the fractured portion 114. The fractured portion 114 is formed of, for example, a heat-shrinkable tube, a tape with an adhesive material, or an adhesive agent which is applied in a predetermined range and then cured. The end surface of the tube 110a and the distal tip 111 may be adhesively fixed. In this case, the adhesive layer interposed between the tube 110a and the distal tip 111 also forms the fractured portion 114.
When the tube 110a and the distal tip 111 can be bonded with sufficient strength, the fractured portion 114 that covers the joint between the tube 110a and the distal tip 111 may not be provided. In this case, only the adhesive layer interposed between the tube 110a and the distal tip 111 forms the fractured portion 114.
By breaking the fractured portion 114, the distal tip 111 can be separated from the endoscope 100 without being damaged. The separated distal tip 111 can be reused when assembling a new endoscope 100. That is, the distal tip 111 performs the function of the reusable portion R in which it is reused, and the function of the single-use portion S in which the other portion is disposed after being used once.
In addition, when the end surface of the tube 110a and the distal tip 111 are bonded and fixed, it is desirable to use an adhesive that can be easily peeled off at a predetermined temperature or by using a predetermined solvent or the like. The predetermined temperature or the predetermined solvent is a temperature or a solvent that is not used in a medical institution during an endoscopic examination. By doing so, it is possible to provide the endoscope 100 in which the distal tip 111 can be removed without damage.
The treatment tool channel 31, the air supply channel 32, the water supply channel 33, the auxiliary water supply channel 34, and the wire channel 35 have a circular cross section. The end portion of the treatment tool channel 31 forms the forceps port 121a. The end portion of the air supply channel 32 forms the air supply port 121b. The end portion of the water supply channel 33 forms the water supply port 121c. The end portion of the auxiliary water supply channel 34 forms the auxiliary water supply port 121d.
The description will be continued using
The wire sheath 42 is, for example, a tight coil or a flexible tube. The wire sheath 42 is an example of the rigid member described in the first embodiment. One end of the wire sheath 42 is fixed to the operation unit body 131. The wire sheath 42 may be fixed to the inner wall of the wire channel 35 over the entire length of the soft portion 113.
The thick diameter retaining portion 411 is provided at one end of the angle wire 41. The retaining portion 411 is fitted into the end portion of the wire channel 35. The other end of the angle wire 41 is connected to a bending mechanism (not illustrated) inside the operation unit body 131.
When the user operates the bending mechanism, the angle wire 41 moves back and forth in the wire sheath 42 in the longitudinal direction. By pulling the angle wire 41 toward the operation unit side, the portion where the angle wire 41 projects from the wire sheath 42 becomes shorter. As a result, the bending section 112 bends toward the pulled-in angle wire 41 side.
The inner surface of the forceps port 121a and the inner surface of the treatment tool channel 31 smoothly communicate with each other to form a channel that is a passage of the treatment tool. The treatment tool inserted by the user from the treatment tool inlet 132 projects from the distal tip of the insertion portion 110 via the treatment tool channel 31 and the forceps port 121a.
Although illustration is omitted, the inner surface of the air supply port 121b and the inner surface of the air supply channel 32 are in smooth communication. The inner surface of the water supply port 121c and the inner surface of the water supply channel 33 are in smooth communication. The inner surface of the auxiliary water supply port 121d and the inner surface of the auxiliary water supply channel 34 are in smooth communication.
The cable channel 36 has a substantially oval cross section. A cable 44 is inserted through the cable channel 36. The end portion of the cable 44 is connected to the power source connector 110c and the signal connector 110d. In the end portion of the cable channel 36, the power source connector 110c and the signal connector 110d are embedded in a holding block 110e.
A power source cable that supplies power to the image sensor 124 is connected to the power source connector 110c. A signal cable for transmitting a signal between the image sensor 124 and the processor 3 is connected to the signal connector 110d. In the following description, the power source cable and the signal cable may be collectively referred to as the cable 44.
A driver IC and a multiplexer may be arranged between the cable 44 and the power source connector 110c and the signal connector 110d. The numbers of cables 44, power source connectors 110c, and signal connectors 110d are arbitrary. One cable channel 36 having a circular cross section may be provided for one cable 44. The cable channel 36 for the power cable 44 and the cable channel 36 for the signal cable 44 may be provided separately.
The distal tip 111 does not have an opening at a location corresponding to the wire channel 35 and the cable channel 36. The distal tip 111 covers the end portions of the wire channel 35 and the cable channel 36.
The operation unit side of the insertion portion 110 is covered with an outer cover 51. The outer cover 51 is, for example, a heat shrinkable tube or an elastic resin tube. The outer cover 51 may be a layer formed by spirally winding an adhesive tape around the tube 110a. The outer cover 51 may be a layer obtained by spirally winding a resin tape around the tube 110a and then heating and fusing the resin tape. The outer cover 51 may be a layer in which a liquid resin material is applied to the outer peripheral surface of the tube 110a and cured.
The flexural rigidity of the portion of the soft portion 113 covered with the outer cover 51 may be higher than the flexural rigidity of the portion which is not covered with the outer cover 51. Therefore, the boundary between the portion covered with the outer cover 51 and the portion not covered with the outer cover 51 forms the rigidity changing position P1 described using
The configuration of the endoscope 100 described with reference to
L0, L1, L2, and Leff indicate the lengths from the distal tip of the insertion portion 110 described using
N1<N2<N3 (1)
A method of measuring the flexural rigidity of the bending section 112 and the soft portion 113 will be described. The measuring instrument used for the measurement is the same as the measuring instrument described using
The amount D1 of indentation and the distance D2 between the rollers W1 in
The roller W2 is arranged so as to prevent the object to be measured outside the roller W1 from moving in the direction opposite to the indentation direction when the measuring rod L is pushed in. As long as this function is fulfilled, the distance between the rollers W2 is arbitrary. The above function can be realized by setting the distance between the rollers W2 to a value around from D2+2d to d2+4d when the outer diameter of the object to be measured is indicated by d.
Incidentally, when a portion having an outer diameter of 7.0 mm or less and a portion exceeding 7.0 mm coexist in the insertion portion 110 of one endoscope 100, both portions are measured using the condition when the outer diameter of any portion is 7.0 mm or less.
A case where the flexural rigidity N1 of the bending section 112 is measured will be described. The tube 110a that is sufficiently longer than the distance between the rollers W2 is prepared. The angle wire 41 and the cable 44, which are longer than the tube 110a, are inserted into the tube 110a. Through the above steps, the measurement sample is completed.
The measurement sample is arranged between the roller W1 and the roller W2 in the state of being straightened as described using
A case of measuring the flexural rigidity N2 of the first region 1131 will be described. The first region 1131 is straightened. When the first region 1131 is sufficiently long, the first region 1131 is arranged between the rollers W2. When the first region 1131 is shorter than the interval between the rollers W2 and longer than the interval between the rollers W1, the central portion of the first region 1131 is arranged so as to be located at the central portion between the rollers W1. The reaction force when the roller W3 is pushed in by a predetermined amount D1 of indentation is the flexural rigidity of the first region 1131.
When the first region 1131 is shorter than the distance between the rollers W1, the tube 110a that is sufficiently longer than the distance between the rollers W2 is prepared. The wire sheath 42, the angle wire 41, and the cable 44, which are longer than the tube 110a, are inserted into the tube 110a. Through the above steps, the measurement sample is completed.
The measurement sample is arranged between the roller W1 and the roller W2 in the state of being straightened as described using
A case where the flexural rigidity N3 of the second region 1132 is measured will be described. Generally, the second region 1132 is longer than the distance between the rollers W2. The second region 1132 extends straightly. The second region 1132 is arranged between the rollers W2. The reaction force when the roller W3 is pushed in by a predetermined amount D1 of indentation is the flexural rigidity of the second region 1132.
When the endoscope 100 can be disassembled for measurement, measurement is performed according to the following procedure. First, the flexural rigidity of the second region 1132 is measured. When the first region 1131 is longer than the interval between the rollers W1, the flexural rigidity of the first region 1131 is measured by the procedure described above.
When the first region 1131 is shorter than the interval between the rollers W1, the outer cover 51 is removed from the side closer to the first region 1131 and the portion having the same configuration as the first region 1131 is increased. After securing a sufficient length for the portion having the same structure as the first region 1131, the flexural rigidity of the first region 1131 is measured.
After that, the insertion portion 110 is removed from the operation unit 130, or the insertion portion 110 is cut at a position close to the operation unit 130. The wire sheath 42 is removed to secure a sufficient length for the portion having the same configuration as the bending section 112. After that, the flexural rigidity of the bending section 112 is measured in the same procedure as the above-mentioned first region 1131.
Tables 4 and 5 illustrate examples of suitable endoscopes 100. The unit of the tube outer diameter, L1, L2 and Leff is mm. The unit of N1, N2 and N3 is Newton. L0 is about 10 mm to 20 mm.
Table 4 indicates the endoscope 100 for the upper digestive tract. No. 1 indicates the endoscope 100 for the upper digestive tract, which is suitable for nasal insertion and pediatric use. No 2 indicates the endoscope 100 suitable for general upper endoscopic examination. No 3 indicates the endoscope 100 suitable for endoscopic treatment and the like.
Table 5 indicates a respiratory endoscope 100 and a urinary endoscope 100. No. 4 indicates the endoscope 100 for a respiratory organ. Compared to the endoscope 100 for the upper digestive tract illustrated in No. 1 to No. 3, the effective length Leff is short and the flexural rigidity is small. Since the flexural rigidity is small, it is possible to provide the endoscope 100 that smoothly bends along the bronchus even when it is inserted into the bronchus that extends toward the upper lobe of the lung.
No. 5 indicates the endoscope 100 for urology. The effective length Leff is even shorter than that of the respiratory endoscope 100 indicated in No. 4. No. 6 indicates the endoscope 100 for a so-called baby scope. Since it is inserted into the pancreaticobiliary duct via the channel of the endoscope 100 for duodenum, it has a small outer diameter and a long effective length Leff.
Note that No. 1 to No. 6 are all examples, and the specifications and uses of the endoscope 100 are not limited to these.
<First Example of Second Modification of Endoscope>
A first example of the second modification of the second embodiment relates to the endoscope 100 in which the outer cover 51 has the function of the fractured portion 114. Descriptions regarding common parts with the second embodiment will be omitted.
The outer cover 51 of this modification example includes a first outer cover 511 and a second outer cover 512. The first outer cover 511 continuously covers about half of the outer peripheral surface of the distal tip 111 on the operation unit side and the outer peripheral surface of the tube 110a. The second outer cover 512 covers the first outer cover 511 on the operation unit side of the insertion portion 110.
The first outer cover 511 and the second outer cover 512 are made of the same material and manufacturing method as outer cover 51 of the second embodiment. The material and manufacturing method of the first outer cover 511 and the second outer cover 512 may be the same or different.
The portion of the first outer cover 511 that covers the joint between the tube 110a and the distal tip 111 serves as the fractured portion 114 of this modification. The flexural rigidity of the portion of the soft portion 113 covered with the two layers of the first outer cover 511 and the second outer cover 512 is higher than the flexural rigidity of the portion covered with only the first outer cover 511. Therefore, the boundary between the portion covered with the second outer cover 512 and the portion not covered with the second outer cover 512 forms the rigidity changing position P1 described using
Similarly, the portion of the soft portion 113 that is covered only with the first outer cover 511 forms the first region 1131, and the portion that is covered with two layers of the first outer cover 511 and the second outer cover 512 forms the second region 1132.
According to this modification, the first outer cover 511 can provide the endoscope 100 in which the flexural rigidity of the bending section 112 and the first region 1131 is enhanced.
<Second Example of Second Modification of Endoscope>
A second example of the second modification of the second embodiment relates to the endoscope 100 in which the outer cover 51 has the function of the fractured portion 114. Descriptions regarding common parts with the second embodiment will be omitted.
The outer cover 51 of this modification includes a thin region 516 and a thick region 517. The thin region 516 covers the distal tip side portion of the outer peripheral surface of the tube 110a. The thick region 517, which is thicker than the thin region 516, covers a portion of the outer peripheral surface of the tube 110a that is not covered by the thin region 516. The thin region 516 and the thick region 517 are integrally formed.
The flexural rigidity of the portion of the soft portion 113 that is covered by the thick region 517 is higher than the flexural rigidity of the portion covered by the thin region 516. Therefore, the boundary between the thin region 516 and the thick region 517 forms the rigidity changing position P1 described using
According to this modification, the material of the surface of the insertion portion 110 does not change before and after the rigidity changing position P1. It is possible to provide the endoscope 100 in which when a doctor who is a user inserts the insertion portion 110 into a patient, it is difficult for the doctor to feel discomfort such as a change in surface slipperiness.
<Third Example of Second Modification of Endoscope>
A third example of the second modification of the second embodiment relates to the endoscope 100 in which the outer cover 51 has the function of the fractured portion 114. Descriptions regarding common parts with the second embodiment will be omitted.
The outer cover 51 of this modification example includes a first outer cover 511 and a second outer cover 512. The first outer cover 511 covers the distal tip side portion of the outer peripheral surface of the tube 110a. The second outer cover 512 covers the portion of the outer peripheral surface of the tube 110a that is not covered with the first outer cover 511. The second outer cover 512 is formed of a material harder than the first outer cover 511. The first outer cover 511 and the second outer cover 512 have almost the same thickness.
The flexural rigidity of the portion of the soft portion 113 covered with the second outer cover 512 is higher than the flexural rigidity of the portion covered with the first outer cover 511. Therefore, the boundary between the portion covered with the first outer cover 511 and the portion covered with the second outer cover 512 forms the rigidity changing position P1 described using
According to this modification, the thickness of the insertion portion 110 hardly changes before and after the rigidity changing position P1. It is possible to provide the endoscope 100 in which when a doctor who is a user inserts the insertion portion 110 into a patient, it is difficult for the doctor to feel discomfort due to a change in the thickness of the insertion portion 110.
<Fourth Example of Second Modification of Endoscope>
A fourth example of the second modification of the second embodiment relates to the endoscope 100 in which the distal tip 111 includes the fixing protrusion 54. Descriptions regarding common parts with the second embodiment will be omitted.
The distal tip 111 includes a fixing protrusion 54 that protrudes from the surface on the tube 110a side. The fixing protrusion 54 has a sharp distal tip and has a retainer. The fixing protrusion 54 pierces the end surface of the tube 110a and fixes the distal tip 111 to the tube 110a.
Note that
This embodiment relates to the endoscope 100 in which the flexural rigidity changes at two positions, a rigidity changing position P1 and a rigidity changing position P2, which are provided in the middle of the soft portion 113. Descriptions regarding common parts with the second embodiment will be omitted.
The structure of the insertion portion 110 around the rigidity changing position P1 and the rigidity changing position P2 is similar to that around the rigidity changing position P1 according to the second embodiment or its modification. The structure around the rigidity changing position P1 and the structure around the rigidity changing position P2 may be the same or different.
The portion of the soft portion 113 from the distal tip side to the rigidity changing position P1 forms the first region 1131. Similarly, the portion from the rigidity changing position P1 to the rigidity changing position P2 forms the second region 1132. The portion from the rigidity changing position P2 to the distal tip of the folding portion 135 forms the third region 1133.
Since the distance L0 to the distance L1 and the effective length Leff are the same as those in the second embodiment, the description thereof will be omitted. The distance from the distal tip of the insertion portion 110 to the rigidity changing position P1 is described as L2. The distance from the distal tip of the insertion portion 110 to the rigidity changing position P2 is described as L3. L3 is longer than L2.
L0, L1, L2, L3, and Leff indicate the lengths from the distal tip of the insertion portion 110 described using
N1<N2<N3<N4 (2)
The method of measuring the flexural rigidity N4 of the third region 1133 is the same as the method of measuring the flexural rigidity N3 of the second region 1132 described in the second embodiment, and thus the description thereof is omitted.
Table 6 indicates an example of the suitable endoscope 100. The unit of the tube outer diameter, L1, L2, L3 and Leff is mm. The unit of N1, N2, N3 and N4 is Newton.
No. 7 indicates an example of the endoscope 100 for duodenum. The endoscope 100 for duodenum often adopts a so-called side-view type configuration having an observation window 24, an illumination window 27, the forceps port 121a, and the like on the side surface of the distal tip 111. Since the side-view endoscope 100 has been conventionally used, the illustration of the configuration of the distal tip 111 is omitted. L0 of No. 7 is about 31 mm.
No. 8 and No. 9 indicate examples of the endoscope 100 for the large intestine. As indicated in the bottom of Table 6, for each of No. 8 and No. 9, there are three variations in effective length Leff of 1300 mm, 1500 mm and 1700 mm. L0 of No. 8 and No. 9 is about 10 to 20 mm.
According to this embodiment, since the flexural rigidity changes at two locations, it is possible to provide the endoscope 100 that is easy for the user to insert it into the patient even at a site that is difficult to insert, such as the sigmoid colon, the spleen curve, and the liver curve. The flexural rigidity may change at three or more places.
Note that No. 7 to No. 9 are all examples, and the specifications and uses of the endoscope 100 are not limited to these.
This embodiment relates to the endoscope 100 in which the flexural rigidity of the soft portion 113 is uniform. Descriptions regarding common parts with the second embodiment will be omitted.
L0, L1, and Leff indicate the lengths from the distal tip of the insertion portion 110 described using
N1<N2 (3)
Table 7 indicates an example of a suitable endoscope 100. The unit of the tube outer diameter, L1 and Leff is mm. The unit of N1 and N2 is Newton. L0 is about 10 mm to 20 mm.
No. 10 indicates the endoscope 100 for a respiratory organ. Compared to the endoscope 100 for a respiratory organ indicated in No. 4, the diameter is smaller, the effective length Leff is shorter, and the flexural rigidity is smaller. It is possible to provide the endoscope 100 that can be easily inserted even in a patient with a narrow trachea such as children.
No. 11 indicates a so-called baby scope endoscope 100. Compared with the endoscope 100 for baby scope indicated in No. 6, the diameter is smaller and the flexural rigidity is smaller. It is possible to provide the endoscope 100 for a baby scope which can be combined with the endoscope 100 for a duodenum having a channel diameter smaller than that of No. 6.
No. 12 indicates the endoscope 100 for endotracheal intubation used for inserting a tracheal tube when performing general anesthesia. For endotracheal intubation, for example, the respiratory endoscope 100 described in No. 4 may be used. However, in endotracheal intubation, it is not necessary to insert the endoscope 100 up to the bronchus. Therefore, for endotracheal intubation, as illustrated in No. 12, the endoscope 100 in which the flexural rigidity of the entire insertion portion 110 is uniform can be used.
Note that No. 10 to No. 12 are all examples, and the specifications and uses of the endoscope 100 are not limited to these.
Technical features (constitutional requirements) described in the respective embodiments can be combined with each other, and new technical features can be formed with the combination.
The embodiments disclosed herein are exemplary in all respects, and it should be considered that the embodiments are not restrictive. The scope of the invention is defined not by the above-described meaning but by claims, and intends to include all modifications within meaning and a scope equal to claims.
(Appendix 1)
An endoscope comprising:
an insertion portion including an imaging unit; and
an operation unit for bending a part of the insertion portion,
wherein at least a part of the insertion portion is configured by a resin tube,
wherein the tube has a plurality of resin channels forming the tube,
wherein the insertion portion includes a distal tip including the imaging unit, a bending section that is bent by the operation unit, and a soft portion between the bending section and the operation unit,
wherein at least a part of the bending section and the soft portion is configured by the tube,
wherein a Shore A hardness of the resin is A30 or more and A95 or less,
wherein a rigid member inserted into the channel, and an angle wire inserted into the rigid member and connected to a bending mechanism of the bending section are included, and
wherein the operation unit is provided to operate the angle wire.
(Appendix 2)
The endoscope according to Appendix 1, wherein the Shore A hardness of the resin in the bending section is lower than the Shore A hardness of the resin in the soft portion.
(Appendix 3)
The endoscope according to Appendix 1 or 2, wherein the Shore A hardness of the resin changes in an axial direction or a radial direction of the tube.
(Appendix 4)
The endoscope according to Appendix 1, wherein the rigid member has a flexural rigidity higher than that of the tube, and is inserted into the channel in the soft portion.
(Appendix 5)
The endoscope according to any one of Appendices 1 to 4, wherein the insertion portion has a fractured portion that is fractured when the imaging unit is removed.
(Appendix 6)
An endoscope comprising an insertion portion including an imaging unit and an operation unit for bending a part of the insertion portion,
wherein at least a part of the insertion portion is configured by a resin tube,
wherein the tube has a plurality of resin channels forming the tube,
wherein the insertion portion includes a distal tip including the imaging unit, a bending section that is bent by the operation unit, and a soft portion between the bending section and the operation unit,
wherein at least a part of the bending section and the soft portion is configured by the tube,
wherein a Shore A hardness of the resin is A30 or more and A95 or less,
wherein a single-use portion including the tube that is replaced after each use, and a reusable portion including the imaging unit that is collected and reused for each use are included.
(Appendix 7)
The endoscope according to Appendix 6, wherein the Shore A hardness of the resin changes in an axial direction or a radial direction of the tube.
(Appendix 8)
The endoscope according to Appendix 6 or 7, wherein the Shore A hardness of the resin in the bending section is lower than the Shore A hardness of the resin in the soft portion.
(Appendix 9)
The endoscope according to any one of Appendixes 6 to 8, comprising a rigid member inserted into the channel, and an angle wire inserted into the rigid member and connected to a bending mechanism of the bending section,
wherein the operation unit is provided to operate the angle wire.
(Appendix 10)
The endoscope according to Appendix 9, wherein the rigid member has a flexural rigidity higher than that of the tube, and is inserted into the channel in the soft portion.
(Appendix 11)
The endoscope according to any one of Appendixes 6 to 10, wherein the insertion portion has a fractured portion that is fractured when the imaging unit is removed.
Number | Date | Country | Kind |
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2018-129478 | Jul 2018 | JP | national |
Filing Document | Filing Date | Country | Kind |
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PCT/JP2019/024525 | 6/20/2019 | WO | 00 |