The present application is based upon and claims the benefit of priority from Japanese Patent Application Nos. JP2007-123833 and JP2007-123834, both filed on May 8 of 2007, the entire disclosure of which is incorporated herein by reference.
1. Field of the Invention
The present invention relates an insertion assisting tool and, in particular, relates to an insertion assisting tool for medical use which assists the insertion of an endoscope for observing a small intestine and a large intestine etc. into a human body. Further, the invention relates to an insertion assisting tool for an endoscope which includes an endoscope insertion portion to be inserted and a balloon provided at the outer periphery portion of the tip end thereof.
2. Description of Related Art
Since the deep portion of an alimentary canal such as a small intestine and a large intestine is bent complicatedly, the force is difficult to transmit to the tip end of the insertion portion by merely pushing the insertion portion of the endoscope into the deep portion of the alimentary canal, and so the insertion into the deep portion is difficult. Thus, there is proposed a method in which the insertion portion of the endoscope is inserted into an insertion assisting tool of a tubular shape (also called as an over tube or a sliding tube) and then inserted into a human body. According to this method, since the insertion portion is guided by the insertion assisting tool, the insertion portion can be prevented from excessively bending or curving and so can be inserted into the deep portion of the alimentary canal (see JP-A-10-248794, for example).
JP-A-2002-301019 discloses an endoscope apparatus in which a first balloon is provided at the tip end of the insertion portion of the endoscope and a second balloon is provided at the tip end of the insertion assisting tool. According to this endoscope apparatus, the insertion portion and the insertion assisting tool can be fixed at the alimentary canal by inflating the first balloon and the second balloon. Thus, the insertion portion can be inserted into the deep portion of the alimentary canal by alternatively inserting the insertion portion and the insertion assisting tool while repeatedly inflating and shrinking the balloons.
The insertion assisting tool disclosed in JP-A-2002-301019 is separately provided with a tube of a thin diameter for supplying fluid to the second balloon. This tube is attached to the outer periphery of the insertion assisting tool. Thus, since the flexibility of the insertion assisting tool degrades, there arises a problem that the insertion operability of the insertion assisting tool into a human body degrades and also the insertion operability of the insertion portion of the endoscope into the insertion assisting tool degrades. In contrast, an insertion assisting tool disclosed in JP-A-2006-81930 is arranged in a manner that a feed path for supplying fluid to a balloon is formed at the peripheral wall portion of the insertion assisting tool. Thus, since the insertion assisting tool is configured by a single tube, the flexibility of the insertion assisting tool is good, and so the insertion operability of the insertion assisting tool into a human body as well as the insertion operability of the insertion portion of the endoscope into the insertion assisting tool is excellent.
However, in the insertion assisting tool disclosed in JP-A-2006-81930, since the peripheral wall portion thereof protrudes inside at the position of the feed path, there arises a problem that the protrusion portion rubs when the insertion portion of the endoscope is inserted into and extracted from the insertion assisting tool. In particular, in the endoscope apparatus for observing a large intestine or a small intestine, since the insertion portion of the endoscope is repeatedly inserted into and extracted from the insertion assisting tool, a lubricant coating is formed on the inner peripheral surface of the insertion assisting tool. However, when the protrusion portion is provided like the patent document 2, since the protrusion portion rubs with the insertion portion of the endoscope, the lubricant coating may be come off and so the insertion/extracting operation may encounter with an obstacle.
In order to solve such problems, it is considered to protrude the peripheral wall portion of the insertion assisting tool to the outside or to increase the entire thickness of the peripheral wall portion of the insertion assisting tool. However, according to the former method, the protrusion portion on the outside of the insertion assisting tool may scratch the inner wall of the body cavity when the insertion assisting tool is inserted into and extracted from the body cavity. According to the latter method, since the entire thickness of the peripheral wall portion increases, the flexibility of the insertion assisting tool may degrade.
In the double balloon type endoscope apparatus disclosed in JP-A-2002-301019, when, for example, the second balloon is inflated and closely fitted to the intestinal wall and thereafter, an operation of moving the over tube in the extracting direction is performed, the over tube cannot be smoothly moved. Namely, this is considered to result from addition of compression to the air stored at a base end part side of the over tube with respect to the second balloon (air stored in a gap between the over tube and the intestinal wall) by the operation of the over tube, and the air pressure caused by this gives a difficulty to the extracting operation of the over tube.
In contrast, an insertion assisting tool disclosed in Japanese Patent No. 3804068 is arranged in a manner that a ventilation hole is provided on the base end side of a second balloon attaching position of the insertion assisting tool and the ventilation hole is opened to the base end portion of the insertion assisting tool via an air ventilation tube provided separately from an insertion path for the insertion assisting tool.
According to the insertion assisting tool, when the insertion assisting tool is extracted in the inflated state of the second balloon of the insertion assisting tool, the air stored in the gap between the insertion assisting tool and the intestinal wall enters from the ventilation hole of the insertion assisting tool and is exhausted to the outside of a human body via the insertion assisting tool. Thus, the insertion assisting tool is not applied with the air pressure at the time of the extracting operation of the insertion assisting tool. Accordingly, the extracting operation of the insertion assisting tool can be performed smoothly.
However, also in the insertion assisting tool for an endoscope having the ventilation hole disclosed in Japanese Patent No. 3804068, there arises a case that the air stored in the gap between the insertion assisting tool and the intestinal wall is not smoothly exhausted to the outside of a human body from the ventilation hole.
The invention was made in view of the aforesaid circumstances and an object of an illustrative, non-limiting embodiment of the invention is to provide an insertion assisting tool which can prevent the local rubbing with the insertion portion of an endoscope and has good flexibility.
Another object of an illustrative, non-limiting embodiment of the invention is to provide, in an insertion assisting tool having a ventilation hole, an insertion assisting tool for an endoscope which can surely exhaust air or liquid stored in a gap between the insertion assisting tool and an intestinal wall via the ventilation hole as an opening portion.
These objects can be attained by the following aspects.
(1) In an insertion assisting tool including an insertion path in which an insertion portion of an endoscope is inserted, and a tube for fluid which is formed along an axial direction thereof at a tubular wall portion of the insertion path, the insertion path has a circular shape in its section orthogonal to the axial direction, and the tube is configured in a manner that a sectional shape thereof along the axial direction is longer in a circumferential direction than a radial direction.
(2) In the insertion assisting tool according to (1), the two is disposed on each side of the insertion path.
(3) In the insertion assisting tool according to (2), the tube disposed on one side of the insertion path is adapted to supply and suck air to and from a balloon which is attached to an outer periphery of a tip end portion of the insertion assisting tool, and the tube disposed on the other side of the insertion path is adapted to ventilate via a ventilation opening formed on a base end side than an attachment position of the balloon.
(4) In the insertion assisting tool according to (1), the insertion assisting tool further includes a balloon which is freely inflatable and shrinkable and which is disposed at an outer peripheral portion of a tip end of the insertion assisting tool; and an outer peripheral portion having an opening on a base end side of the insertion assisting tool than an attachment position of the balloon, wherein the opening has an elongated shape, and a longitudinal direction of the opening is along a longitudinal direction of the tube.
(5) In the insertion assisting tool according to (4), the outer peripheral portion has a plurality of openings with an interval along the tube.
(6) In the insertion assisting tool according to (4), an opening area of the opening is set to be larger than a sectional area of the tube orthogonal to the axial direction thereof.
(7) In the insertion assisting tool according to (4), an edge of the opening is subjected to a chamfering processing.
According to the aspect of (1), since the tube is configured to be short in the radial direction and long in the circumferential direction, a sufficient area of the tube can be secured while suppressing the insertion assisting tool from protruding at the position of the tube. Further, according to the aspect of (1), since the insertion path has a circular sectional shape and has no protruding portion on the inner periphery thereof, the inner peripheral surface can be prevented from being locally rubbed at the time of relatively inserting and extracting the insertion portion of the endoscope.
According to the aspects (2) and (3), since the two tube is provided in each side of the insertion path, it becomes difficult to bend the insertion assisting tool on the side where the tube is provided (that is, the radial direction of the tube) and becomes easy to bend on the side where the tube is not provided (that is, the circumferential direction of the tube). In the case where the insertion assisting tool is bent on the side where the tube is not provided, since the tube is formed to be long in the bent direction, the tube is not crushed and so the area of the tube can always be secured.
According to the aspect (4), the opening acting as a ventilation opening is formed to have the elongated shape, the longitudinal direction of which is along the longitudinal direction of the fluid tube.
In the insertion assisting tool disclosed in Japanese Patent No. 3804068, the reason why air stored between the insertion assisting tool and the intestinal wall can not be exhausted smoothly from the ventilation hole is that the ventilation hole is closed by the intestinal wall. Thus, the basic reason why the ventilation hole is closed by the intestinal wall has been investigated and found that the ventilation hole of Japanese Patent No. 3804068 is a perfect circle and the basic reason causing such a problem resides in the shape of the ventilation hole.
According to the aspect (4), in the case where the inner wall of the body cavity adheres to the opening portion, since the opening portion is formed in the elongated shape, the entirety of the opening portion can be more unlikely closed as compared with the opening portion of the perfect circle. Thus, since the exhausting function of the opening portion can be maintained, the air and liquid reserved between the insertion assisting tool and the intestinal wall can be surely exhausted to the outside of a human body from the opening portion.
According to the aspect (5), of the plurality of the opening portions, even if one of the opening portions is closed by the inner wall of the body cavity adhering thereto, air and liquid can be exhausted to the outside of a human body from the remaining opening portion not being closed.
According to the aspect (6), since the opening area of the opening portion is set to be larger than the sectional area of the tube orthogonal to the axial direction of a fluid path, the exhausting efficiency of air and liquid can be improved.
According to the aspect (7), since the edge of the opening portion is subjected to the chamfering processing, the inner wall of the body cavity can be prevented from being caught by the opening portion, so that the operability of inserting and extracting the insertion assisting tool with respect to the inner wall of the body cavity can be improved. Thus, pain of a patient due to the catch of the inner wall of the body cavity by the opening portion can be relieved. Further, the edge of the opening portion is an edge on the outer surface side of the insertion assisting tool and at least the edge almost orthogonal to the insertion and extracting direction of the insertion assisting tool may be subjected to the chamfering processing.
The features of the invention will appear more fully upon consideration of the exemplary embodiment of the invention, which are schematically set forth in the drawings, in which:
wherein some of the reference numerals and signs in the drawings are set forth below
According to an exemplary embodiment of the invention, since the sectional shape of the insertion path is a circle and the sectional shape of the tube is set to be short in the radial direction and long in the circumferential direction, the insertion path can be prevented from being locally rubbed. Further, a sufficient area of the tube can be secured while suppressing the insertion assisting tool from protruding at the position of the tube.
Further, according to another embodiment, since the opening portion acting as a ventilation hole is formed in the elongated shape which longitudinal direction is along the axial direction of the insertion assisting tool, the entirety of the opening portion can be more unlikely closed as compared with the opening portion of the perfect circle. Thus, since the exhausting function of the opening portion can be maintained, the air and liquid reserved between the insertion assisting tool and the intestinal wall can be surely exhausted to the outside of a human body from the opening portion.
Hereinafter, the insertion assisting tool according to an exemplary embodiment of the invention will be explained with reference to attached drawings.
The endoscope 10 includes a hand side operating portion 14 and an insertion portion 12 which is provided so as to continue from the hand side operating portion 14 and inserted within a human body. A universal cable 16 is coupled to the hand side operating portion 14 and an LG connector 18 is provided at the tip end of the universal cable 16. The LG connector 18 is coupled to a light source device 20 so as to be detachable freely, whereby illumination light is transmitted to illumination optical systems 54 described later (see
The hand side operating portion 14 is provided with an air supply/liquid supply button 28, a suction button 30, a shutter button 32 and a function switching button 34 and further provided with a pair of angle knobs 36, 36.
The insertion portion 12 is configured by a soft portion 40, a curved portion 42 and a tip end portion 44 in the order from the hand side operating portion 14 side. The curved portion 42 is remotely operated so as to curve by rotating the angle knobs 36, 36 of the hand side operating portion 14, whereby the tip end portion 44 can be directed to a desired direction.
As shown in
The outgoing light end of a light guide (not shown) is disposed on the rear side of the illumination optical systems 54, 54. The light guide is inserted into the insertion portion 12, the hand side operating portion 14 and the universal cable 16 shown in
The air supply/liquid supply nozzle 56 shown in
The forceps port 58 shown in
On the other hand, the insertion assisting tool 60 shown in
The tube main body 64 is formed by elastic material such as polyurethane and is formed in an almost tubular shape in which the insertion portion 12 of the endoscope 10 is inserted. A balloon 66, which is freely inflatable and shrinkable, is attached to the outer periphery of the tip end portion of the tube main body 64. Air is supplied from the balloon control device 100 to the balloon 66 and sucked from the balloon by the balloon control device. The detail of the insertion assisting tool 60 will be described in detail later.
The balloon control device 100 shown in
The device main body 102 is provide on the front surface thereof with a power supply switch SW1, a stop switch SW2 and a pressure display portion 106. The pressure display portion 106 is a panel for displaying a pressure value of the balloon 66, and an error code is displayed on the pressure display portion 106 at the time of occurrence of an abnormality such as a breakage of the balloon.
A tube (or a cable) 108 for supplying and sucking air to and from the balloon 66 is coupled to the front surface of the device main body 102. A reverse flow preventing unit 110 is provided at the coupling portion between the tube 108 and the device main body 102. The reverse flow preventing unit 110 is configured by incorporating an air/liquid separation filter within a casing (not shown) of a hollow disc shape detachably attached to the device main body 102. When the balloon 66 is broken, the filer can prevent liquid such as body fluid from flowing into the device main body 102.
The hand switch 104 is provided with various kinds of switches. For example, there are provided with a stop switch having the same function as the stop switch SW2 on the device main body 102 side, an ON/OFF switch for instructing the increase/decrease of the pressure within the balloon 66 and a pause switch for maintaining the pressure within the balloon 66. The hand switch 104 is electrically coupled to the device main body 102 via a cord 112. Although not shown in
The balloon control device 100 thus configured can supply air to the balloon 66 to inflate it, control the air pressure within the balloon at a constant value to hold the balloon 66 to the inflated state, suck air from the balloon 66 to shrink it, and control the air pressure within the balloon at a constant value to hold the balloon 66 to the shrunk state.
The balloon control device 100 is coupled to a balloon dedicated monitor 114, whereby at the time of inflating or shrinking the balloon 66, the pressure value and the inflated/shrunk state of the balloon 66 can be displayed on the balloon dedicated monitor 114. The pressure value and the inflated/shrunk state of the balloon 66 may be displayed on the monitor 50 in a manner of being superimposed on the observed image of the endoscope 10.
Next, the 60 according to the embodiment will be explained with reference to
As shown in
The insertion path 70 is a tube into which the insertion portion 12 (see
The fluid tube 72 for the balloon shown in
As shown in
The tip end side of the tube 72 is closed at the fixing portion of the tip end 66A of the balloon 66 and the tip end side than the fixing position. The base end side of the tube 72 is coupled to a tube 88 with a small diameter (see
The ventilation tube 74 shown in
The ventilation tube 74 communicates with the outside via openings 90, 90, 90 for ventilation formed at the outer peripheral surface of the tube main body 64. The ventilation openings 90, 90, 90 are formed with a constant interval on the base end side than the attachment position of the balloon 66. As shown in
As shown in
As shown in
As shown in
The balloon 66 is formed in an almost tubular shape which center portion is expanded, and the tip end portion 66A of the balloon is covered by the concave portion 82 of the tube main body 64 in a reversed state thereof. A string 92 is wound around the tip end portion 66A of the balloon 66 and adhesive 94 is pasted on the string, so that the tip end portion 66A of the balloon 66 is fixed to the tube main body 64. In this state, the balloon 66 is restored into an original state and the base end portion 66B of the balloon 66 is covered by the concave portion 84. Then, a string 92 is wound around the base end portion 66B of the balloon 66 and adhesive 94 is pasted on the string, so that the base end portion 66B of the balloon 66 is fixed to the tube main body 64. In this manner, the tip end portion 66A and the base end portion 66B of the balloon 66 are fixed to the concave portions 82, 84, respectively. In this case, since the tip end portion 66A and the base end portion 66B of the balloon 66 are disposed at the concave portions 82, 84, respectively, the fixing portions are suppressed from protruding outwardly.
As shown in
As shown in
The connectors 76, 86, 96 shown in
The tube main body 64 can be manufactured by processing a multi-lumen tube by using a mould shown in
Although not shown, the multi-lumen tube before the processing has a tip end surface, a base end surface and an outer peripheral surface. After the processing, three holes to be the insertion path 70, the tube 72 and the tube 74 respectively are formed in the axial direction within the multi-lumen tube so as to penetrate between the tip end surface and the base end surface, and the sectional shape orthogonal to the axis is formed to be uniform always. First, the cored bar 120 is inserted into the multi-lumen tube and the embossing dies 122, 124 are pressed toward the multi-lumen tube from the outside. The embossing dies 122, 124 are heated to a predetermined temperature (for example, 100 to 110 degrees centigrade) while pressing the multi-lumen tube by the embossing dies 122, 124 to thereby form the tube main body 64 having the two concave portions 82, 84 and the tapered portion 65.
The tube main body 64 manufactured in this manner forms a space 134 closed by the two concave portions 82, 84 (that is, two closed portions) as shown in
The tube main body 64 manufactured by the aforesaid manufacturing method is configured in a manner that the closing position of the fluid tube 72 for the balloon (that is, the concave portion 82) is separated from the opening 80 in the axial direction and the semi-closed space 136 is formed on the tip end side than the opening 80. Thus, when air is supplied via the tube 72, the semi-closed space 136 can absorb the pressure deviation of the air blown out from the opening 80.
Further, since the tube main body 64 is provided with the two concave portions 82, 84, these concave portions 82, 84 act as indices at the time of fixing the tip end portion 66A and the base end portion 66B of the balloon 66, so that the tip end portion 66A and the base end portion 66B of the balloon 66 can be surely fixed at the desired positions, respectively. Thus, it is possible to prevent such a phenomenon that the distance between the tip end portion 66A and the base end portion 66B of the balloon 66 is too short or too large, and hence the expansion coefficient of the balloon 66 can be controlled accurately. Further, since the tip end portion 66A and the base end portion 66B of the balloon 66 are fixed to the concave portions 82, 84, respectively, the concave portions 82, 84 act as catching portions for the fixing means such as the string 92 and the adhesive 94, the balloon 66 can be fixed firmly.
Next, the explanation will be made as to the operation method of the endoscope apparatus configured in the aforesaid manner. In the endoscope apparatus configured in the aforesaid manner, first the insertion portion 12 and the insertion assisting tool 60 are alternatively inserted in a pushing manner and the insertion assisting tool 60 is fixed within a cavity of a human body (for example, a large intestine) while inflating the balloon 66 if necessary. Then, the insertion assisting tool 60 is mobbed in the extracting direction to thereby simplify the tubular shape of the cavity (for example, a large intestine), and the insertion portion 12 is further inserted into the deep portion of the cavity. For example, the insertion portion 12 is inserted from the anus of a person to be tested, then the balloon 66 is inflated almost when the tip end of the insertion portion 12 passes a sigmoid colon, and the insertion assisting tool 60 is fixed to the intestinal canal. Then, the insertion assisting tool 60 is pulled to form the sigmoid colon in an almost straight shape, and the tip end of the insertion portion 12 is inserted into the deep portion. In this manner, the insertion portion 12 can be inserted into the deep portion of the sigmoid colon.
Of the aforesaid operations, in the operation for moving the insertion assisting tool 60 in the extracting direction in the inflated state of the balloon 66, as shown in
The insertion assisting tool 60 according to the embodiment employs the multi-lumen tube having integrally-formed tubes as shown in
As shown in
As shown in
Further, as shown in
As to the processing method of the opening 90, firstly as shown by a steady line in
Next, the explanation will be made as to the action of the insertion assisting tool 60 according to the embodiment.
As explained above, the insertion path 70 is configured to have a circular shape in its section along the axial direction and so has no portion protruding from the inner peripheral surface thereof. Thus, even in the case where the insertion portion 12 of the endoscope 10 is inserted into the insertion path 70 and the insertion and extracting operation is performed repeatedly, such phenomenon can be prevented from occurring that the inner peripheral surface of the insertion path 70 is locally rubbed and the lubricant coating is exfoliated. That is, as shown in
Further, according to the embodiment, each of the tubes 72, 74 is configured in a manner that the sectional shape thereof along the axial direction is an ellipse which is short in the radial direction and long in the circumferential direction. Thus, the tube main body 64 can be prevented from protruding to the outside while securing a sufficient sectional area of each of the tube 72 and the tube 74. That is, as shown in
Further, in this embodiment, the paths 72, 74 are disposed in an opposite manner via the insertion path 70 therebetween. Since the tubes 72, 74 are disposed in this manner, it becomes difficult to bent the tube main body 64 in the upper and lower direction in
Although in the aforesaid embodiment, the sectional shape of each of the tubes 72, 74 is set to be an ellipse, the sectional shape of each of the tubes 72, 74 is not limited thereto and other shapes may be employed so long as its sectional shape is short in the radial direction and long in the circumferential direction. Thus, like the tubes 72, 74 shown in
Although the aforesaid embodiment is explained as to a case where the tube 72 and the tube 74 are formed with an interval of 180 degree therebetween, it is sufficient so long as these tubes are disposed almost in an opposite manner via the insertion path 70 therebetween.
Although the aforesaid embodiment is explained as to a case of a single balloon type in which the balloon 66 is attached only to the insertion assisting tool 60, the endoscope may be configured as a double-balloon type endoscope apparatus in which a freely inflatable and shrinkable balloon is also attached to the insertion portion 12 of the endoscope 10. In this case, the tip end of the insertion portion 12 can be inserted into the deep portion of an intestine by repeatedly performing the insertion operation for inserting the insertion portion 12 of the endoscope 10, the fixing operation for inflating the balloon on the insertion portion 12 side to thereby fix the insertion portion 12, the pushing operation for pushing the insertion assisting tool 60 along the insertion portion 12, the gripping operation for inflating the balloon 66 to thereby grasp the intestine and the drawing operation for drawing the insertion assisting tool 60.
Number | Date | Country | Kind |
---|---|---|---|
P2007-123833 | May 2007 | JP | national |
P2007-123834 | May 2007 | JP | national |