1. Field of the INVENTION
The present invention relates to a medical instrument provided with image pickup means which is left indwelling and fixed to the inside of the abdominal wall of a patient.
2. Description of the Related Art
As is well known, endoscope apparatuses, which are medical instruments, are provided with an image pickup apparatus, which is image pickup means, designed to be introduced into a body cavity of a patient and perform various types of inspections and treatments of affected areas in the body based on observed images taken by the image pickup apparatus. Examples of such endoscopes include those introduced into digestive organs such as esophagus, stomach, large intestine and duodenum, which are tube cavities and tubes in the body from the oral cavity or anus and those introduced into the abdominal cavity from the vicinity of the umbilical region by puncturing through the body wall.
In order to obtain a sufficient illumination light quantity to take images using the image pickup apparatus of such an endoscope, for example, Japanese Patent Application Laid-Open Publication No. 2001-37717 discloses an endoscope apparatus including a cover with a light exit window for illumination light provided in an insertion portion, wherein the cover is rotated to cause the light exit window to face an object and to thereby increase the illumination light quantity. When inserted into or removed from the body, this conventional endoscope apparatus closes the cover so as to prevent the outside diameter of the insertion portion from increasing.
On the other hands, in addition to inspection inside the digestive tract, surgical operations that conduct therapy or treatment while observing organs in the body, so-called “laparoscopic surgical operations” are becoming a focus of attention in recent years. This laparoscopic surgical operation is a minimally-invasive operation which, rather than creating a large opening in the abdomen performs treatment by puncturing, through the abdomen of the patient, a trocar that guides an observation endoscope into the body cavity and a trocar that guides a treatment instrument to a treatment region and introducing the endoscope into the abdominal cavity.
A medical instrument of the present invention is a medical instrument used by being introduced into a body and fixed thereto, including a fixing section fixed to a body wall in the body, an image pickup section that picks up an image of an object to be examined in the body, an illumination section that illuminates the object to be examined in the body, and a sheet body in which the illumination section is disposed and which is made unfoldable so as to form a plane that spreads over a wide angle from a direction orthogonal to a central axis of the illumination section in an illumination direction so that an irradiation region of illumination light is expanded in an image pickup region of the image pickup section and a wide range is irradiated with the illumination light.
Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings. In the following descriptions, for example, a medical apparatus provided with a medical instrument for conducting an abdominal cavity laparoscopic surgical operation will be illustrated.
First, a camera set up in the abdominal cavity, which is a medical instrument according to the present invention used for an abdominal cavity laparoscopic surgical operation, will be described below.
As shown in
The camera unit 2 is configured by including a camera body 7 incorporating a solid image pickup device such as CCD or CMOS and an image pickup unit 8 provided with an objective lens group that condenses image taking light to the solid image pickup device and a dome-like transparent cover body 9 disposed on one surface which is a front surface of the camera body 7.
The above described cable 6 extends from the center of the other surface which is a rear surface of the camera body 7. This cable 6 is a composite cable for supplying power to the image pickup unit 8 of the camera unit 2 and illumination sections 20 (see
The opening/closing section 3 is configured by including a plurality of (here eight) ribs 11, a plurality of (here eight) stretchers 12, one ends of which are pivotably attached to the ribs 11, and a sheet body 15, which is a thin-film to which the ribs 11 are radially pasted in uniform spacing.
The plurality of ribs 11 are each provided, at some midpoint thereof, with a pivot support section 11a at which one end of the stretcher 12 is pivotably connected. One ends of the ribs 11 are individually pivotably connected to a plurality of pivot support sections 7a disposed on the back surface of the camera body 7 of the camera unit 2 and protective bodies 13 formed of a quasi-spherical elastic member are provided at the other ends of the ribs 11. This protective body 13 is intended to prevent edges of the ribs 11 introduced into the body from damaging body tissue.
The stretchers 12 pivotably connected to the pivot support sections 11a of the ribs 11 at one ends are individually pivotably connected, at the other ends thereof, to a plurality of pivot support sections 4a provided on the other surface opposite to the surface on which the suction cup 5 of the abdominal wall fixing section 4 is disposed.
In the above described configuration, the plurality of ribs 11 or the plurality of stretchers 12 pivot about the respective pivot support sections 4a, 7a and 11a through a pulling/slackening operation of the cable 6, which is operation means, and the opening/closing section 3 is thereby configured to be made changeable between an open state in which the plurality of ribs 11 are radially expanded and a closed state in which the plurality of ribs 11 are placed close to each other.
Accordingly, the sheet body 15 pasted to the plurality of ribs 11 is made changeable between the open state as shown in
A plurality of (here, four) illumination sections 20, which are plane light sources, are disposed on surfaces of the sheet body 15 between the neighboring ribs 11. For example, plane light sources of organic EL are used for these illumination sections 20 so that the illumination sections 20 are deformable even when the sheet body 15 is folded. Power to the illumination sections 20 is configured to be supplied from the cable 6 through the camera unit 2 via wiring (not shown).
The camera 1, which is a medical instrument of the present embodiment in such a configuration is used for an abdominal cavity laparoscopic surgical operation and used to take images of a treatment region when an organ or the like in the abdominal cavity 101, which is one of the body cavities of the patient is treated as shown in
First, the camera 1 of the present embodiment is introduced into the abdominal cavity 101 of the patient via a trocar punctured into the abdominal wall 102. The cable 6 of the camera 1 is held by a puncture needle (not shown) or the like and pulled out of the body passing through abdominal wall 102.
Next, the cable 6 of the camera 1 is passed through a hole 21a of a fixing unit 21 provided on the abdomen side of the patient and pulled toward the abdominal wall 102 side. The cable 6 is pulled toward the outside of the body until the suction cup 5 of the camera 1 sticks fast to the inner surface of the abdominal wall 102.
When the cable 6 is further pulled toward the outside of the body in this state, the camera unit 2 is lifted so as to come closer to the abdominal wall fixing section 4, the plurality of ribs 11 or the plurality of stretchers 12 pivot about the respective pivot support sections 4a, 7a and 11a, and the plurality of ribs 11 thereby spread radially and the opening/closing section 3 is placed in an open state. As shown in
The fixing unit 21 is provided with a fixing lever 22 that fixes the cable 6 of the camera 1 outside the body. A hole 22a through which the cable 6 passes is formed at some midpoint of the fixing lever 22 and the fixing lever 22 is urged toward one side of the fixing unit 21 by a spring 23 provided in the fixing unit 21 so that the position of the hole 22a is deviated from the position of the hole 21a of the fixing unit 21.
That is, when the user pushes the fixing lever 22 into the fixing unit 21 up to a position at which the hole 21a of the fixing unit 21 substantially matches the hole 22a of the fixing lever 22 against the urging force of the spring 23, the user can easily pull the cable 6. When the user stops pushing the fixing lever 22 into the fixing unit 21, the fixing lever 22 then slides by receiving the urging force of the spring 23.
Therefore, since the position of the hole 22a of the fixing lever 22 deviates from the position of the hole 21a of the fixing unit 21, the cable 6 of the camera 1 that passes through the holes 21a and 22a is sandwiched and fixed in the fixing unit 21. The opening/closing section 3 of the camera 1 is thereby kept in an open state.
As described above, according to the camera 1 of the present embodiment, the four illumination sections 20 provided around the camera unit 2 spread over a wide range as the sheet body 15 of the opening/closing section 3 unfolds, and it is thereby possible to irradiate the image taking region of the image pickup unit 8 in the camera unit 2 with illumination light of sufficient brightness and luminous intensity distribution. That is, with the provision of the illumination sections 20 that unfold and spread when used and that can make variable the area of irradiation of illumination light, in other words, irradiation region to be expanded, in such a small camera 1 of the present embodiment that is introduced into the abdominal cavity, it is possible to improve the brightness of illumination light and luminous intensity distribution characteristics. Thus, the camera 1 can have a configuration capable of obtaining sufficient illumination light to illuminate the object.
The camera 1 may also be configured so as to wirelessly transmit an image signal to an external device. In this case, by providing an antenna in the sheet body 15 of the opening/closing section 3, it is also possible to improve directivity of the antenna.
Next, a second embodiment of the camera set up in the abdominal cavity, which is a medical instrument of the present invention will be described below using
The camera set up in the abdominal cavity (hereinafter also simply referred to as “camera”) 30 of the present embodiment is configured by including a rectangular thin-film sheet body 31, a camera unit 32, which is image pickup means, disposed at substantially the center of one surface of the sheet body 31 and four illumination sections 33, which are illumination means, provided around the camera unit 32 of the sheet body 31 as shown in
As in the case of the first embodiment, the camera unit 32 is provided with a solid image pickup device such as CCD or CMOS and an objective lens group that condenses image taking light to this solid image pickup device. Furthermore, the camera unit 32 of the present embodiment incorporates an image pickup unit including a battery. The camera 30 has a configuration in which a video signal photoelectrically converted by the image pickup unit of the camera unit 32 is wirelessly transmitted to a receiver of an external device by a transmitter provided in the camera unit 32.
The four illumination sections 33 are configured to irradiate illumination light onto an object using, for example, LED light sources or organic EL plane light sources. When LEDs are used as light sources, the illumination sections 33 of the present embodiment are arranged on the sheet body 31 in the same longitudinal direction, that is, in parallel. Furthermore, these illumination sections 33 receive a power supply from a battery in the camera unit 32.
When the camera 30 of the present embodiment is not used, the sheet body 31 is deformed into a quasi-cylindrical shape as shown in
This sheet body 31 is formed, for example, of a polyurethane-based shape-memory polymer, and a water-activated adhesive making up means for fixing to the body wall is applied to the other entire surface opposite to the one surface on which the camera unit 32 and four illumination sections 33 are disposed. This water-activated adhesive is an adhesive whose adhesive force is generated when a contact is made with the wet abdominal wall 102 and which has bio compatibility such as fibrin-based adhesive/sticker, albumin-based adhesive/sticker or cyanoacrylate-based adhesive/sticker.
Furthermore, the sheet body 31 has a characteristic that its rigidity versus temperature changes as shown in
That is, the sheet body 31 has a high modulus of rigidity and is hard at a low temperature and solidified when deformed into a quasi-cylindrical shape as shown in
The camera 30 of the present embodiment configured as shown above and in a quasi-cylindrical shape as shown in
After introducing the camera 30 into the abdominal cavity 101, the user irradiates illumination light of the endoscope 100 introduced into the abdominal cavity 101 via another trocar 105 onto the entire sheet body 31 and warms up the sheet body 31 using this illumination light to a glass transition point temperature Tg or above. The sheet body 31 warmed up to the glass transition point temperature Tg or above then becomes softer, and therefore the user spreads the sheet body 31 so as to unfold using, for example, two treatment instruments 110 as shown in
The user then causes the surface of the sheet body 31 to which an adhesive is applied to be pasted to the abdominal wall 102 using, for example, the two treatment instruments 110 as shown in
As described above, with the camera 30 of the present embodiment as in the case of the first embodiment, the four illumination sections 33 provided around the camera unit 32 spread over a wide range as the sheet body 31 unfolds, and it is thereby possible to irradiate the image taking region of the image pickup unit in the camera unit 32 with illumination light of sufficient brightness and luminous intensity distribution.
That is, the camera 30 can be configured such that when introduced into the abdominal cavity 101, the sheet body 31 is rounded into a quasi-cylindrical shape and deformed into a shape so as to be able to pass through the trocar 105, warmed up with illumination light of the endoscope 100 when used, and the sheet body 31 is thereby made changeable so as to be unfolded and spread to increase the area irradiated with illumination light from the illumination sections 33. This allows the camera 30 to improve the brightness of illumination light and luminous intensity distribution. Thus, the camera 30 can have a configuration capable of obtaining sufficient illumination light to illuminate the object to be examined.
As the method of warming up the sheet body 31, heat generated when the illumination sections 33 of the camera 30 light up may be used instead of using heat of illumination light of the endoscope 100.
Next, a first modification example of the camera 30 of the present embodiment will be described based on
The camera 30 of this modification example shown in
The solar panels 34 directly receive illumination light of the endoscope 100 used together with the camera 30 (see
The configuration of the solar panels 34 serving as the solar power generation sections is not limited to the present embodiment, but is also applicable to configurations of the above described first embodiment and the following embodiments.
Next, a second modification example of the camera 30 of the present embodiment will be described based on
The camera 30 of this modification example shown in
Thus, provision of the antenna 35 over a wide range of the sheet body 31 allows the camera 30 to improve directivity of radio wave that wirelessly transmits an image signal photoelectrically converted by the image pickup unit in a camera unit 32 to an external device and transmit the image signal efficiently.
Next, a camera set up in the abdominal cavity according to a third embodiment, which is a medical instrument of the present invention, will be described below using
As shown in
A water-activated adhesive which makes up means for fixing to the body wall is applied to the surface of the elastic wire 41. This water-activated adhesive is an adhesive whose adhesive force is generated when a contact is made with the wet abdominal wall 102 as in the case of the second embodiment, which has biocompatibility such as fibrin-based adhesive/sticker, albumin-based adhesive/sticker or cyanoacrylate-based adhesive/sticker.
As in the case of the second embodiment, the camera unit 43 is provided with a solid image pickup device such as CCD or CMOS, and this solid image pickup device is provided with an objective lens group that condenses image taking light and incorporates an image pickup unit including a battery. Furthermore, as in the case of the second embodiment, the camera 40 is configured such that a video signal photoelectrically converted by the image pickup unit of the camera unit 43 is wirelessly transmitted to a receiver in an external device by a transmitter provided in the camera unit 43.
The four illumination sections 44 are configured to irradiate illumination light onto an object from film-shaped plane light sources of organic EL. Furthermore, these illumination sections 44 receive a power supply from a battery in the camera unit 43 as in the case of the second embodiment.
As shown in
The camera 40 introduced into the abdominal cavity 101 is restored to the ring shape as shown in
As described above, in the camera 40 of the present embodiment as in the cases of the above described embodiments, the four illumination sections 44 provided around the camera unit 43 spread over a wide range as the sheet body 42 unfolds, and it is thereby possible to irradiate the image taking region of the image pickup unit in the camera unit 43 with illumination light of sufficient brightness and luminous intensity distribution.
Furthermore, since the ring-shaped elastic wire 41 is provided around the sheet body 42, it is possible to easily fold and deform the camera 40 when the camera 40 is introduced into the abdominal cavity 101 and allow the camera 40 to easily pass through the trocar 105. Furthermore, when used, the camera 40 can be configured such that the sheet body 42 easily unfolds and spreads back into a disk shape by an elastic force of the elastic wire 41 (see
Next, a fourth embodiment of a camera set up in the abdominal cavity, which is a medical instrument of the present invention will be described using
As shown in
In the rotation section 51, a bar-shaped opening/closing section 51a extends from one side and one side of the sheet body 54 is pasted to the opening/closing section 51a.
As in the case of the second embodiment, the camera unit 52 of the present embodiment is also provided with a solid image pickup device such as CCD or CMOS and an objective lens group that condenses image taking light to this solid image pickup device and incorporates an image pickup unit including a battery. The embodiment has a configuration in which a video signal photoelectrically converted by the image pickup unit of the camera unit 52 is also wirelessly transmitted to a receiver of an external device by a transmitter provided in the camera unit 52.
In the abdominal wall fixing section 53, a bar-shaped opening/closing section 53a also extends from one side and the other side of the sheet body 54 is pasted to this opening/closing section 53a.
The sheet body 54 is made changeable from the folded state shown in
The illumination sections 55 of the present embodiment also have a configuration of irradiating illumination light onto the object to be examined using film-shaped plane light sources of organic EL. As in the case of the above described embodiments, these illumination sections 55 also receive a power supply from a battery in the camera unit 43.
In the abdominal wall fixing section 53, as shown in
An end of the operation wire 56 is fixed to the pulley 58 of the shaft body 57 and the operation wire 56 is wound around the pulley 58. This operation wire 56 is wounded around the pulley 58 with the extending direction thereof changed by two rotating bodies 59a provided in the abdominal wall fixing section 53. Furthermore, the operation wire 56 is inserted into the suction cup 5 via a hole 53b formed in the center of the top surface of the abdominal wall fixing section 53 and extends outward.
In the camera 50 configured as described above, when the operation wire 56 wound around the pulley 58 is pulled in the abdominal wall fixing section 53, the rotation section 51 fixed to the shaft body 57 rotates with respect to the abdominal wall fixing section 53 against an urging force of the spiral spring 59. As shown in
As described above, the camera 50 of the present embodiment is introduced into the abdominal cavity 101, and can be made changeable, when used, to a state in which the folded sheet body 54 is unfolded and spread by pulling the operation wire 56. Thus, in the camera 50, the illumination section 55 provided in the sheet body 54 spreads over a wide range as in the case of the above described embodiments, and it is thereby possible to irradiate the image taking region of the image pickup unit in the camera unit 43 with illumination light of sufficient brightness and luminous intensity distribution.
Next, a fifth embodiment of a camera set up in the abdominal cavity, which is a medical instrument according to the present invention will be described below using
As shown in
The body section 61 is provided with a suction cup 5 making up means for fixing to the body wall disposed on a surface opposite to the surface on which the camera unit 64 is disposed as in the case of the first embodiment and a cable 6 extends from this suction cup 5. Furthermore, a hinge section 63 is provided in the joint between the body section 61 and the support plate 62 so that the support plate 62 is freely opened/closed with respect to the body section 61.
The sheet body 65 is disposed on the underside of the body section 61 on which the camera unit 64 is provided and includes an illumination section (not shown), which is illumination means. This sheet body 65 is unfolded into a fan shape and provided with creases so as to be foldable like bellows.
That is, the sheet body 65 is connected to the support plate 62 and the body section 61 at both ends and is made changeable between states in which the sheet body 65 is unfolded/spread and folded like a fan by opening/closing the support plate 62. The support plate 62 is opened/closed with respect to the body section 61 through an opening/closing operation using the treatment instrument 110 such as the aforementioned grasping forceps.
As described above, also with the camera 60 of the present embodiment, the support plate 62 is opened with respect to the body section 61 and the sheet body 65 is thereby unfolded to spread and the illumination section provided on the sheet body 65 spreads over a wide range, and it is thereby possible to irradiate the image taking region of the image pickup unit in the camera unit 64 with illumination light of sufficient brightness and luminous intensity distribution.
Next, a sixth embodiment of a camera set up in the abdominal cavity, which is a medical instrument according to the present invention will be described below using
As shown in
Furthermore, the body section 71 incorporates a camera unit 76, which is image pickup means, provided with a dome-shaped transparent cover 76a which is disposed so as to be exposed. This camera unit 76 is provided with a solid image pickup device such as CCD or CMOS and an objective lens group that condenses image taking light to this solid image pickup device as in the case of the first embodiment.
The telescopic section 73 has a plurality of bars provided in a grid-like shape and these bars are connected to each other so that pivoted sections where the bars cross each other are made rotatable. Thus, the telescopic section 73 is configured so as to extend or contract in both sideward directions of the body section 71 by the respective bars rotating around the pivoted sections.
The two sheet bodies 74 are provided with a plurality of creases in the short-side direction to form a strip-shaped configuration and a plurality of illumination sections 75, which are illumination means using organic EL as plane light sources, are disposed on the planes between the creases. That is, the sheet bodies 74 can be folded along the creases.
The sheet body 74 is connected to the body section 71 at one end in the longitudinal direction and connected to the support body 72 provided at the other end of the telescopic section 73, and is thereby made changeable between an open state in which the sheet body 74 is unfolded to spread and a closed state in which the sheet body 74 is folded along creases according to expansion/contraction of the telescopic section 73. That is, the sheet bodies 74 are placed in an open state in which the sheet bodies 74 unfold and spread in two opposing directions (separating from each other) orthogonally to the image taking optical axis of the camera unit 76 in a direction away from the camera unit 76. Furthermore, the sheet bodies 74 are placed in a closed state in which the sheet bodies 74 are folded along creases in two opposing directions (separating from each other) orthogonally to the image taking optical axis of the camera unit 76 in a direction approximating to the camera unit 76.
As described above, in the camera 70 of the present embodiment, the sheet body 74 unfolds and spreads with the expansion of the telescopic section 73 and the illumination sections 75 provided in the sheet body 74 spread over a wide range, making it possible to irradiate the image taking region of the image pickup unit in the camera unit 76 with illumination light of sufficient brightness and luminous intensity distribution.
The expansion/contraction operation of the telescopic section 73 can be performed by operating the support body 72 using the treatment instrument 110 such as the aforementioned grasping forceps. Furthermore, each bar of the telescopic section 73 may be formed, for example, of a Ni-Ti-based shape-memory alloy and each bar may store the shape thereof so that the telescopic section 73 expands and the sheet body 74 unfolds and spreads when the camera 70 is introduced into the abdominal cavity 101 and the telescopic section 73 is warmed up to a body temperature.
Next, a modification example of the camera 70 of the present embodiment will be described below based on
As shown in
Each sheet body 77 is connected to the body section 71 via a connection body 77 formed of a Ni-Ti-based shape-memory alloy. This connection body 78 extends on the one side of the sheet body 77 and makes up a support section that supports the sheet body 77.
The camera 70 configured in this way is introduced into the abdominal cavity 101, and when the connection body 78 that supports the sheet body 77 is warmed up by a body temperature, each sheet body 77 springs up from the side of the body section 71. That is, when warmed up by the body temperature, the connection body 78 has shape-memory stored therein so as to cause each supported sheet body 77 to spring up from the side of the body section 71.
As described above, the camera 70 of this modification example is configured such that when introduced into the abdominal cavity 101 and warmed up by the body temperature, the sheet bodies 77 provided with the illumination sections 75 naturally spring up from the body section 71 and the illumination sections 75 spread over a wide range so as to irradiate the image taking region of the image pickup unit in the camera unit 76 with illumination light of sufficient brightness and luminous intensity distribution.
Next, a seventh embodiment of a camera set up in the abdominal cavity, which is a medical instrument according to the present invention will be described below using
As shown in
Each slide body 83 is provided with a support body 83a with an end of the sheet body 85 connected to an end that protrudes from the side of the body section 81 and an outward flange 83b is formed at the other end in the body section 81. These slide bodies 83 are inserted through springs 84 in the body section 81.
The spring 84 is disposed so that one end thereof contacts the inner wall of the body section 81 and the other end contacts the outward flange 83b of the slide body 83.
One end of each sheet body 85 is connected to the support body 83a of the slide body 83 and the other end thereof is connected to the wall surface of the body section 81. Each sheet body 85 is provided with an illumination section using organic EL as a plane light source on the underside thereof.
The mobile body 86 is connected to the operation wire 86a at the top end thereof and is disposed in the body section 81 so that this top end becomes the vertex. This operation wire 86a passes through the top surface of the body section 81 and extends outward via the suction cup 5. Furthermore, the end of the slide body 83 urged by the spring 84 is always in contact with the surface of the mobile body 86.
In the camera 80 configured as described above, when the mobile body 86 is lifted by pulling the operation wire 86a as shown in
Thus, in the camera 70 of the present embodiment, the two sheet bodies 85 are unfolded and spread as the respective slide bodies 83 move and the illumination sections provided on the sheet bodies 85 spread over a wide range, and it is thereby possible to irradiate the image taking region of the image pickup unit in the camera unit 82 with illumination light of sufficient brightness and luminous intensity distribution.
According to the medical instrument, which is the present invention according to the above described embodiments, even when a small configuration is adopted, it is possible to irradiate an object to be examined, images of which are taken by an image pickup apparatus, with illumination light of sufficient brightness and luminous intensity distribution.
As an application of the camera unit, which is the image pickup apparatus used in the present invention, the techniques in the aforementioned embodiments are also applicable to cases where in an operation of extirpating a tumor of thoracic cavity or abdominal cavity, 5-ALA (aminolevulinic acid) is administered by mouth, intravenous injection or the like before or after operation, and lymph node or pleural metastasis, peritoneal metastasis or the like to which a malignant tumor is suspected to have metastasized is irradiated with excitation light and images of fluorescence generated from the 5-ALA (aminolevulinic acid) are thereby picked up.
Furthermore, the techniques in the aforementioned embodiments are also applicable to cases where a diagnosis is made by observing fluorescence using an image pickup apparatus (e.g., endoscope, surgical field camera) during an operation, and such a diagnosis is made by removing fat or membrane that constitutes an impediment to the observation.
Number | Date | Country | Kind |
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2008-264502 | Oct 2008 | JP | national |
This application is a continuation application of PCT/JP2009/066295 filed on Sep. 17, 2009 and claim benefit of Japanese Application No. 2008-264502 filed in Japan on Oct. 10, 2008, the entire contents of which are incorporated herein by this reference.
Number | Date | Country | |
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Parent | PCT/JP2009/066295 | Sep 2009 | US |
Child | 12719299 | US |