JP3853931B2 - Endoscope - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to an endoscope, and more particularly to an endoscope characterized by the arrangement of forceps openings with respect to a plurality of observation windows for observing a subject.
[0002]
[Prior art]
In recent years, autofluorescence from a living body using an endoscope or the like, a drug is injected into a living body, fluorescence of the drug is detected as a two-dimensional image, and a disease state such as degeneration of a living tissue or cancer (for example, There are techniques for diagnosing disease types and infiltration ranges.
[0003]
When light is irradiated onto a living tissue, fluorescence having a wavelength longer than that of the excitation light is generated. Examples of fluorescent substances in the living body include NADH (nicotinamide adenine nucleotide), FMN (flavin mononucleotide), pyridine nucleotide and the like. Recently, the interrelationship between such endogenous substances and diseases has become clear. In addition, HpD (hematoporphyrin), photofrin, and ALA (δ-amino levulinic acid) have the ability to accumulate in cancer, and can be diagnosed by injecting this into a living body and observing the fluorescence of the substance. .
[0004]
Such fluorescence is extremely weak, so that extremely high-sensitivity imaging is required for its observation. For example, in Japanese Patent Application Laid-Open No. 8-252218, this high-sensitivity photographing is performed by an imaging device for imaging under white light illumination and a weak self emitted from an observation target under illumination of light in the ultraviolet to blue region. There has been proposed a fluorescence observation endoscope apparatus including a fluorescence observation endoscope having a CCD with an image intensifier as an ultra-sensitive imaging element for imaging fluorescence.
[0005]
According to such a fluorescence observation endoscope, normal observation under white light and autofluorescence observation can be performed selectively or simultaneously, and information on more observation objects than a normal endoscope apparatus Can be provided to the inspector.
[0006]
[Problems to be solved by the invention]
In general, an endoscope is provided with a forceps channel for guiding a treatment tool such as forceps to the distal end of the endoscope, and a biopsy or excision of a lesion in an observation target is performed under endoscopic observation. be able to.
[0007]
However, none of the conventional fluorescence observation endoscopes describe the positional relationship among the white light normal observation objective window, the fluorescence observation objective window, and the forceps hole at the distal end portion of the endoscope.
[0008]
For example, in a conventional fluorescence observation endoscope, as shown in FIG. 6, a normal observation objective window 101 and a fluorescence observation objective window 102 are arranged symmetrically at the top and bottom positions in the figure, as shown in FIG. Illumination windows 103a and 103b are provided in the vicinity of the objective window 101 and the fluorescence observation objective window 102, respectively, and a forceps hole 104, which is an opening on the tip side of the forceps channel, is provided between the normal observation objective window 101 and the illumination window 103b. When the nozzle 105 for cleaning the normal observation objective window 101 and the fluorescence observation objective window 102 is arranged at substantially the center, the forceps 106 is monitored in the white observation image as shown in FIG. Although it protrudes from the lower left on the screen, the forceps 106 protrudes from the upper left on the monitor screen in the fluorescence observation image.
[0009]
That is, in both the normal observation image and the fluorescence observation image, treatment may be performed with the forceps 106 or the like, so that the operator is confused if the position of the forceps 106 on the monitor screen in the normal observation image and the fluorescence observation image is different. There is a problem that it causes.
[0010]
The present invention has been made in view of the above circumstances, and is an endoscope that improves the operability by displaying a treatment instrument such as a forceps at substantially the same position on a monitor image during observation of both white light and fluorescence. The purpose is to provide.
[0011]
[Means for Solving the Problems]
The endoscope according to the present invention is an endoscope including an endoscope insertion portion that is inserted into a subject, and is provided on the distal end surface of the endoscope insertion portion and can be displayed on a predetermined monitor screen A first observation window for observing an object, and an observation window for observing an observation object that is provided on a distal end surface of the endoscope insertion portion and can be displayed on a predetermined monitor screen, On the distal end surface of the endoscope insertion portion, the vertical direction of the observed observation object on the predetermined monitor screen coincides with the vertical direction of the observation object observed on the first observation window. A second observation window arranged at a position where the observation object is observed and a straight line extending in the vertical direction on the predetermined monitor screen of the observation object observed through the center of the first observation window, L1, and the second observation window. Location of the observation object observed through the center of the window A straight line extending in the vertical direction on the monitor screen of L2 passes through the center of the first observation window and passes through the center of the first observation window through L3 and the center of the second observation window. When a straight line extending in a direction perpendicular to the straight line L2 is L4, a region surrounded by the straight line L1 and the straight line L2 and a straight line L3 and the straight line L4 are surrounded on the distal end surface of the endoscope insertion portion. And a forceps opening portion of a forceps channel disposed in the endoscope insertion portion, which is arranged so that the center of its own opening is located in a region excluding the defined region .
[0012]
In the endoscope according to the present invention, the forceps opening may be arranged on the first axis passing through the upper direction and the center in the first observation window and the second axis passing through the upper direction and the center in the second observation window. They are positioned in the same direction with respect to each other, and at the center of the first observation window, are orthogonal to the second axis at the third axis orthogonal to the first axis and at the center of the second observation window. By arranging so as to be located in the same direction with respect to each of the fourth axes, for example, on the monitor image at the time of both white light and fluorescence observation by the first observation window and the second observation window, It is possible to improve the operability by displaying treatment tools such as forceps at substantially the same position.
[0013]
DETAILED DESCRIPTION OF THE INVENTION
Embodiments of the present invention will be described below with reference to the drawings.
[0014]
1 to 5 relate to an embodiment of the present invention, FIG. 1 is a configuration diagram showing a configuration of an endoscope apparatus, and FIG. 2 is a configuration showing a configuration of a distal end surface of an insertion portion of the endoscope of FIG. 3 is a block diagram showing the configuration of a first modification of the distal end surface of the insertion portion of the endoscope of FIG. 1, and FIG. 4 is a second variation of the distal end surface of the insertion portion of the endoscope of FIG. FIG. 5 is an explanatory diagram for explaining the operation of the endoscope of FIG. 1.
[0015]
(Constitution)
In the present embodiment, as shown in FIG. 1, an endoscope apparatus 1 includes an endoscope 2 that is inserted into a body cavity and obtains a normal observation image and a fluorescence observation image of an observation site such as a disease site, and an endoscope. A light source device 3 for supplying illumination light to the mirror 2, a signal processing device 4 for imaging a signal obtained by the endoscope 2, and a monitor 5 for displaying an endoscopic image generated by the signal processing device 4. It is configured with.
[0016]
The endoscope 2 is an elongated insertion portion 11 to be inserted into a body cavity, an operation portion 12 provided at the proximal end of the insertion portion 11, and extends from the operation portion 12 and is detachably connected to the light source device 3. The light guide cable unit 13 and the signal cable unit 14 are detachably connected to the signal processing device 4.
[0017]
A light guide fiber 16 for transmitting illumination light from the light source device 3 from the light guide connector 15 at the tip of the light guide cable portion 13 detachably connected to the light source device 3 to the tip of the insertion portion 11. Is built in, and an illumination window 16a is provided at the distal end portion of the insertion portion 11 on the emission end side of the light guide fiber 16.
[0018]
In addition, a solid-state imaging device 18 for performing normal observation under white light illumination is provided in the distal end portion of the insertion portion 11, and a signal for transmitting a signal from the solid-state imaging device 18 to the signal processing device 4. A signal line 19 is provided. Here, a normal observation objective lens 20 for forming an observation region image on the image sensor 18 and a normal observation objective are formed at the front end of the insertion portion 11 on the imaging surface side of the solid-state image sensor 18. A window 21 is provided.
[0019]
In the insertion portion 11, an image guide fiber 22 for fluorescence observation is provided in parallel with the light guide fiber 16, and the fluorescence observation objective lens 23 is provided at the distal end portion of the insertion portion 11 on the distal end side of the image guide fiber 22. And an observation window 24 for fluorescence observation. A lens 25 and a high-sensitivity imaging element 26 are provided on the proximal end side of the image guide fiber 22 in the operation unit 12 to capture a fluorescent image of an observation site transmitted by the image guide fiber 22. Yes. A signal line 27 for transmitting a signal from the high-sensitivity imaging element 26 to the signal processing device 4 is provided.
[0020]
The signal lines 19 and 27 pass through the signal cable portion 14 and are connected to the signal processing device 4 via the signal cable portion 14.
[0021]
Further, although not shown in FIG. 1, a tube path called a forceps channel for inserting forceps or the like is provided in the insertion portion 11 as in a normal endoscope, and its proximal end side Is opened at the operation portion 12 and the distal end side is opened at the distal end surface of the insertion portion 11. Also, although not shown in FIG. 1, cleaning water for cleaning the normal observation objective window 21 and the fluorescence observation objective window 24 is supplied into the insertion portion 11 as in a normal endoscope. A water supply pipeline is also provided.
[0022]
The light source device 3 is provided with a high-intensity lamp 31 such as xenon or metal halide so that light can be incident on the light guide fiber 16 via a condenser lens 32. A band pass filter (not shown) that allows only blue band light to pass therethrough is provided between the high-intensity lamp 31 and the light guide fiber 16 by a turntable 33.
[0023]
The turntable 33 is operated by a motor 35 controlled by a controller 34. Therefore, under the control of the controller 34, when the band pass filter is inserted in the optical path, only the light in the blue band is incident on the light guide fiber 16, and the band pass filter is retracted from the optical path. White light is incident on the light guide fiber 16.
[0024]
The signal processing device 4 includes a normal observation CCU 41 that images the signal from the solid-state imaging device 18 and a fluorescence observation CCU 42 that images the signal from the high-sensitivity imaging device 26. Observation CCU 41 An image switching unit 43 that selectively outputs an image signal from the fluorescence observation CCU 42 is incorporated.
[0025]
Then, a signal output from the image switching unit 43 is transmitted to the monitor 5, and an image at the distal end of the endoscope is displayed on the screen 51 of the monitor 5.
[0026]
As shown in FIG. 2, at the distal end of the insertion portion 11, the normal observation objective window 21 is disposed substantially at the center, and the fluorescence observation objective window 24 is provided adjacent to the upper portion in the drawing.
[0027]
Illumination windows 16 a and 16 b are provided on both sides of the normal observation objective window 21 and the fluorescence observation objective window 24. This is because the light guide fiber 16 is divided into two at the distal end of the insertion portion 11 so that there is no illumination unevenness, and illumination windows 16a and 16b are provided at the distal ends.
[0028]
A forceps hole 61, which is an opening on the distal end side of the forceps channel inserted into the insertion portion 11, is provided at the lower right of the normal observation objective window 21, and the treatment instrument inserted through the forceps insertion channel is this It protrudes from the forceps hole 61.
[0029]
In addition, a nozzle 62 that is a tip side end portion of the water supply conduit is disposed at the lower left of the normal observation objective window 21, and the nozzle 62 faces the normal observation objective window 21 and the fluorescence observation objective window 24. Opening portions 63a and 63b that are opened at two locations are provided so that the cleaning water is discharged.
[0030]
Here, the forceps holes 61 are not necessarily arranged as shown in FIG. 2, and at least as shown in FIG. 3, for example, an image displayed through the centers of the normal observation window 21 and the fluorescence observation window 24. A straight line that coincides with the vertical direction of L1 and L2, and the normal lines of L1 and L2 that pass through the centers of the normal observation window 21 and the fluorescence observation window 24 are L3 and L4. It suffices if the center of the forceps hole 61 is positioned at the center.
[0031]
As shown in FIG. 4, the nozzle 62 is provided with one nozzle opening 63c so that the nozzle 62 is rotated, so that the normal observation objective window 21 and the fluorescence observation objective window 24 are directed. The cleaning water may be fired.
[0032]
(Function)
Next, the operation of the embodiment configured as described above will be described.
[0033]
First, the insertion portion 11 of the endoscope 2 is inserted into the patient's body while observing under white light illumination.
[0034]
In the white light observation state, in the light source device 3, the bandpass filter of the turntable 33 is retracted from the optical path by the controller 34, and the white light emitted from the high-intensity lamp 31 is incident on the light guide fiber 16. The observation part at the tip of the insertion part 11 is illuminated.
[0035]
In such a state where white light is emitted from the light source device 3, the normal observation CCU 41 in the signal processing device 4 is operated by a control signal from the controller 34 in the light source device 3. Then, the image of the observation site at the tip of the insertion portion 11 is formed on the solid-state imaging device 18 and imaged by the normal observation observation window 21 and the normal observation objective lens 20. The signal of the solid-state imaging device 18 is converted into an image signal by the normal observation CCU 41 and sent to the monitor 5 via the image switching unit 43, and the normal observation image is displayed on the screen 51.
[0036]
When the distal end of the insertion portion 11 reaches the target site for fluorescence observation by normal observation with the endoscope 2, the operator switches to the fluorescence observation state.
[0037]
In the fluorescence observation state, the band pass filter of the turntable 33 is inserted on the optical path by a signal from the controller 34 in the light source device 3, and only the blue light transmitted through the band pass filter is incident on the light guide fiber 16, Illuminate the site. The fluorescence excited from the target site by the blue light is guided from the fluorescence observation objective window 24 to the high-sensitivity image sensor 26 in the endoscope operation section via the image guide fiber 22 and imaged. The signal obtained by the high-sensitivity image sensor 26 is converted into an image signal by the fluorescence observation CCU 42 in the signal processing device 4, and a fluorescence image is displayed on the screen 51 of the monitor 5.
[0038]
The solid-state image sensor 18 and the high-sensitivity image sensor 26 in the insertion unit 11 are arranged so that the UP direction shown in FIG. 2 is displayed upward on the screen 51 of the monitor 5. Accordingly, when switching from normal white light observation to fluorescent observation and from fluorescent observation to white light normal observation, an image with substantially the same field of view is displayed on the screen 51 of the monitor 5.
[0039]
When performing biopsy or excision of the tissue to be observed during white light observation or fluorescence observation, the treatment tool is inserted from the forceps insertion port of the operation unit 11 of the endoscope 2 and protruded from the forceps hole 61, and the monitor 5 The work is performed while viewing the endoscopic image displayed on the screen 51.
[0040]
Here, when the normal observation image and the fluorescence observation image are compared, a relatively bright image is obtained in the normal observation image, so that the operation such as treatment becomes easy. On the other hand, a fluorescence observation image has a feature that it is easy to detect a specific region because an image including functional information of a tissue that cannot be seen in a normal observation image is obtained. Therefore, in order to perform an accurate biopsy or excision, it is effective to perform an operation while switching between normal white light observation and fluorescence observation.
[0041]
(effect)
In the present embodiment, by arranging the forceps hole 61 as shown in FIG. 2 with respect to the normal observation objective window 21 and the fluorescence observation objective window 24, as shown in FIG. Usually, in any of the fluorescence observation images displayed above, the treatment tool 71 inserted from the forceps insertion port of the operation unit 11 and projected from the forceps hole 61 is displayed at substantially the same position. You can take action without being confused.
[0042]
In other words, since the treatment tool is displayed at substantially the same position of the endoscopic image on the monitor screen in both the white light normal observation and the fluorescence observation, even if the treatment is performed while switching both observation images, It is possible to operate the treatment tool appropriately and accurately without causing confusion to the surgeon.
[0043]
[Appendix]
(Additional Item 1) In an endoscope inserted into a subject,
A first observation window provided at the distal end of the endoscope;
A second observation window provided at the distal end portion of the endoscope and arranged with its upper direction being directed substantially in the same direction as the upper direction of the first observation window;
The first observation window is located in the same direction with respect to each of the first axis passing through the upper direction and the center and the second axis passing through the center and the second axis passing through the center in the second observation window, and In the same direction with respect to the third axis orthogonal to the first axis at the center of the first observation window and the fourth axis orthogonal to the second axis at the center of the second observation window. An endoscope comprising a forceps port that is disposed so as to be inserted and into which a treatment tool is inserted.
[0044]
(Additional Item 2) First imaging means for imaging the inside of the subject through the first observation window;
The endoscope according to claim 1, further comprising: a second imaging unit that images the inside of the subject through the second observation window.
[0045]
(Additional Item 3) The endoscope according to Additional Item 2, wherein the second imaging unit has higher sensitivity than the first imaging unit.
[0046]
(Additional Item 4) The endoscope according to Additional Item 3, wherein the first imaging unit is a solid-state imaging device provided at a distal end of the insertion portion of the endoscope.
[0047]
【The invention's effect】
As described above, according to the endoscope of the present invention, the forceps opening is provided with the first axis passing through the upper direction and the center in the first observation window and the second axis passing through the upper direction and the center in the second observation window. A fourth axis that is located in the same direction with respect to each of the axes and that is orthogonal to the second axis at the center of the first observation window and the third axis that is orthogonal to the first axis and the center of the second observation window. For example, forceps and the like are treated on the monitor image at the time of both white light and fluorescence observation by the first observation window and the second observation window. There is an effect that the tool can be displayed at substantially the same position and the operability can be improved.
[Brief description of the drawings]
FIG. 1 is a configuration diagram showing a configuration of an endoscope apparatus according to an embodiment of the present invention. FIG. 2 is a configuration diagram showing a configuration of a distal end surface of an insertion portion of the endoscope of FIG. The block diagram which shows the structure of the 1st modification of the front end surface of the insertion part of 1 endoscope. FIG. 4 The structure which shows the structure of the 2nd modification of the front end surface of the insertion part of the endoscope of FIG. FIG. 5 is an explanatory view for explaining the operation of the endoscope shown in FIG. 1. FIG. 6 is a block diagram showing the structure of the distal end surface of the insertion portion of the conventional endoscope. FIG. Explanatory drawing explaining the action of the mirror [Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 ... Endoscope apparatus 2 ... Endoscope 3 ... Light source apparatus 4 ... Signal processing apparatus 5 ... Monitor 11 ... Insertion part 12 ... Operation part 13 ... Light guide cable part 14 ... Signal cable part 15 ... Light guide connector 16 ... Light Guide fiber 16a, 16b ... Illumination window 18 ... Solid-state imaging device 19, 27 ... Signal line 20 ... Normal observation objective lens 21 ... Normal observation objective window 22 ... Image guide fiber 23 ... Fluorescence observation objective lens 24 ... For fluorescence observation Objective window 25 ... Lens 26 ... High-sensitivity imaging device 31 ... High-intensity lamp 32 ... Condensing lens 33 ... Turntable 34 ... Controller 35 ... Motor 41 ... CCU for normal observation
42 ... CCU for fluorescence observation
43 ... Image switching unit 61 ... Forceps hole 62 ... Nozzle 63a, 63b ... Opening

Claims (1)

In an endoscope provided with an endoscope insertion portion to be inserted into a subject,
A first observation window for observing an observation object that is provided on the distal end surface of the endoscope insertion portion and can be displayed on a predetermined monitor screen ;
An observation window provided on the distal end surface of the endoscope insertion portion for observing an observation object that can be displayed on a predetermined monitor screen, the observation target being observed on the distal end surface of the endoscope insertion portion A second observation window arranged at a position where the vertical direction of the object on the predetermined monitor screen matches the vertical direction of the observation object observed on the first observation window on the predetermined monitor screen;
A straight line extending in the vertical direction on the predetermined monitor screen of the observation object observed through the center of the first observation window is L1, and the predetermined object of the observation object observed through the center of the second observation window. A straight line extending in the vertical direction on the monitor screen of L2 passes through the center of the first observation window and passes through the center of the first observation window through L3 and the center of the second observation window. When a straight line extending in a direction perpendicular to the straight line L2 is L4, a region surrounded by the straight line L1 and the straight line L2 and a straight line L3 and the straight line L4 are surrounded on the distal end surface of the endoscope insertion portion. A forceps opening portion of a forceps channel disposed in the endoscope insertion portion, which is disposed so that the center of its own opening is located in a region excluding the defined region;
An endoscope characterized by comprising:

Images