JP5945636B2 - Magnification probe - Google Patents

Description

  The present invention relates to a magnification observation probe that can be inserted into and removed from a treatment instrument insertion channel provided in an insertion portion of an endoscope.

Endoscopes are used in the medical field, industrial field, and the like.
In recent years, for example, in early detection and diagnosis treatment of affected areas such as cancer, it has been noted that it is important to perform histological observation of the mucosal epithelium in the living state, such as the cell structure of the living body, cell nucleus, glandular structure, etc. ing.

  For example, Japanese Patent Application Laid-Open No. 2007-319396 discloses an endoscope and an endoscope system in which the distal end portion is easily positioned and can be stably observed even if the distal end portion of the observation probe is thin. Yes. A high-magnification imaging probe can be inserted into a forceps channel (hereinafter referred to as a treatment instrument insertion channel) provided in the insertion portion of the endoscope. Possible butting balloons are arranged. The abutment balloon is inflated by the supplied air in a state of protruding from the distal end portion of the endoscope, and the front portion of the inflated abutment balloon is brought into contact with the observation site to observe the region of interest at a high magnification. Is done.

Japanese Patent Application Laid-Open No. 2008-054843 discloses an endoscope tip hood and a hooded endoscope. According to an endoscope with a hood, even with an endoscope equipped with an object-contact type observation optical system that is in contact with a living tissue, the surface of the living tissue can be stably observed with a normal observation optical system. In addition, it is possible to stably perform an object contact observation in which an object contact type observation optical system is brought into contact with a biological tissue for observation.
However, in Japanese Patent Application Laid-Open No. 2007-319396, when performing high-magnification observation of a plurality of regions of interest, it is necessary to perform an operation of supplying air and an operation of discharging air in order to repeatedly expand and contract the butting balloon. Yes, there is a risk of stress on the surgeon. When a cylindrical hood main body disclosed in Japanese Patent Application Laid-Open No. 2008-054843 is attached to the tip of a high-magnification imaging probe for stable observation, the probe equipped with the hood main body is used as a treatment tool. It becomes difficult to smoothly insert and remove from the insertion channel, and to ensure that the observation window provided at the tip of the probe is in close contact.

  The present invention has been made in view of the above circumstances, and can be smoothly inserted into and removed from a treatment instrument insertion channel provided in an insertion portion of an endoscope. An object of the present invention is to provide a magnified observation probe that can be observed in close contact with a region of interest in a stable state.

Magnification observation probe of one embodiment of the present invention, the magnification observation probe to the treatment instrument insertion channel provided in the insertion portion of the endoscope is to allow insertion and removal, and the insertion unit for continuously arranged the tip member and the outer tube An observation surface provided on the tip member that can contact the biological mucous membrane, an observation unit for observing the biological mucous membrane in contact with the observation surface, and disposed on the outer peripheral surface of the tip member and forward of the observation surface An annular portion having an inner diameter larger than the outer diameter of the observation surface, a connecting portion provided on a proximal end side from the annular portion and integrally connected to a proximal end portion of the distal end member, and the annular portion And a plurality of divided pieces provided in the circumferential direction for connecting the connecting portion, and the plurality of divided pieces are each deformed into a predetermined shape in a direction intersecting the longitudinal axis of the tip member. Outer diameter direction of the outer peripheral surface Respectively diameter, and the enlarged diameter portion having a plurality of bent portions which permit moving the annular portion on the base end side, of the plurality of divided pieces, the vertical direction in the image observed by the observation unit And an identification unit that is provided in one divided piece at a position corresponding to any one of the two pieces and that makes it possible to identify the one divided piece by an observation image of the endoscope .

The figure explaining the magnification observation probe which provided the holding | maintenance part in the front-end | tip part of the insertion part Top view explaining the holding part The figure explaining the state where the diameter-expanded part of the holding | maintenance part expanded the diameter The figure explaining the state where the diameter-expanded part of the holding | maintenance part expanded the diameter The figure explaining the state where the diameter-expanded part of the holding | maintenance part expanded the diameter The figure explaining the effect | action of the magnification observation probe which has a holding part The figure explaining the effect | action of the magnification observation probe which has a holding part The figure explaining the magnification observation probe from which a holding part is detachable from a tip member

Embodiments of the present invention will be described below with reference to the drawings.
In addition, each drawing used for the following description is shown schematically, and in order to show each component to an extent that can be recognized on the drawing, the dimensional relationship and scale of each member are different for each component. May be shown. Therefore, the present invention is limited only to the illustrated forms, such as the number of components described in these drawings, the shape of the components, the ratio of the sizes of the components, and the relative positional relationship between the components. It is not a thing.

  As shown in FIG. 1, the magnifying observation probe 1 includes an insertion portion 4 composed of a hard distal member 2 and an elongated outer tube 3 connected to the proximal end side thereof, and a holding portion 5.

The tip member 2 is a metal member such as stainless steel, for example, and has an axial through hole in which the high-magnification observation optical system 11 and the illumination optical system 12 are provided.
The illumination optical system 12 includes an illumination window 13 and a light fiber bundle 14.

  The high-magnification observation optical system 11 mainly includes an observation window 15, a high-magnification objective lens group 16, an image sensor (for example, C-MOS) 17 fixed at the imaging position of the lens group 16, and an image sensor. And a signal cable 18 extending from 17.

A distal end surface 2f formed on the distal end side of the distal end member 2 is an observation surface and can contact the biological mucous membrane. The distal end surface 2f is provided with an observation unit configured with an illumination window 13 and an observation window 15 for observing the biological mucous membrane.
Reference numeral 19 denotes a connector, which is detachable from a magnification observation probe video processor (not shown) including an external light source and a signal processing device. The observation magnification of the high-magnification observation optical system 11 is, for example, a monitor magnification of about 200 to 1000 times, and it is possible to observe tissue cells, ray tubes, and the like.

  A circumferential step portion 2 b is provided at the proximal end portion of the distal end member 2. The inner peripheral surface of the distal end portion of the outer tube 3 is disposed on the outer peripheral surface of the circumferential step portion 2b, and is fixed integrally by, for example, bonding.

The holding part 5 is a pipe-shaped flexible tube, which is made of, for example, a fluororesin, has good slipperiness, and has a predetermined hardness.
As shown in FIG.1 and FIG.2, the holding | maintenance part 5 is equipped with the ring 5a which is the cyclic | annular front-end | tip part formed in the ring shape, the enlarged diameter part 5b, and the connection part 5c in order from the front end side. Has been.

The connection part 5c is arrange | positioned at the base end side outer peripheral surface of the front-end | tip member 2, and is integrally fixed by adhesion | attachment, for example. In the state of being integrally fixed, the tip edge 5f located at the tip of the ring 5a is configured to protrude forward from the tip surface 2f of the tip member 2 by a predetermined distance.
The outer diameter of the connecting portion 5c fixed to the tip member 2 and the outer diameter of the outer tube 3 fixed to the circumferential step portion 2b of the tip member 2 are set to be approximately the same size.

  The enlarged diameter portion 5 b is configured by arranging, for example, four divided pieces 6 in the middle of the holding portion 5 in the circumferential direction. In the middle portion, a first dent, a second dent, and a third dent are provided in advance at positions spaced from the tip edge 5f side by a predetermined distance. The recess is a so-called circumferential recess, and the shape of the recess is a U-shape, a U-shape, a V-shape, or the like.

  The four divided pieces 6 have four divided portions 7 having the same shape in the middle portion at equal intervals in the circumferential direction, and the divided portions 7 formed in the same shape have slits, notches, or lengths extending in the axial direction. It is a hole and has an opening on each of the outer peripheral surface and the inner peripheral surface. In the present embodiment, the dividing portion 7 is a long hole having a predetermined shape.

  The distal end of the dividing portion 7 is provided on the distal end side that is separated by a predetermined distance from the distal edge 5f, and the proximal end of the dividing portion 7 is on the distal end side of the connecting portion 5c that is separated by a predetermined distance from the proximal end surface of the holding portion 5. Is provided.

  By forming the above-described divided portions 7 in the middle in the circumferential direction, the enlarged diameter portions 5b in which the four divided pieces 6 are arranged in the circumferential direction are configured. Each of the four divided pieces 6 configured in this manner includes a first bent portion 8a configured by a first recess, a second bent portion 8b configured by a second recess, and a third The 3rd bending part 8c comprised by the hollow is provided. Each bending part 8a, 8b, 8c is comprised so that it may have a predetermined elastic force.

  In the present embodiment, one of the four divided pieces 6 arranged in the direction corresponding to the upward direction on the screen of the image sensor 17 described above (indicated by 6u in the drawing) The divided pieces are colored with different colors so that they can be identified by visual observation from the outside or an observation image by the high-magnification observation optical system 11. In other words, in the present embodiment, the colored pieces 6u are colored as identification means for making it possible to determine the upward direction of the image sensor 17 from the outside or through an observation image by the high-magnification observation optical system 11.

  Each bent portion 8a, 8b, 8c provided on each of the four divided pieces 6 is provided with a predetermined bending ridge against the elastic force of each portion. Specifically, the first bent portion 8a is configured as a first valley fold line 9a1 with a bent ridge, and the second bent portion 8b is configured as a mountain fold line 9b with a bent ridge. The bent portion 8c is configured as a second valley fold line 9a2 by providing a bent ridge.

  Therefore, the enlarged diameter portion 5b is composed of the first enlarged diameter portion 5bf located on the distal end side from the second bent portion 8b and the second enlarged diameter portion 5br located on the proximal side from the second bent portion 8b. The As shown in FIGS. 1 and 2, the outer shape of the enlarged diameter portion 5b is formed into a drum shape having the largest diameter in the vicinity of the second bent portion 8b as shown in FIGS.

  That is, the first enlarged diameter portion 5bf of the enlarged diameter portion 5b is configured as an enlarged diameter inclined surface in which the outer diameter dimension continuously expands from the first bent portion 8a toward the second bent portion 8b. The second enlarged diameter portion 5br is configured as a reduced diameter inclined surface in which the outer diameter dimension is continuously reduced from the second bent portion 8b toward the third bent portion 8c.

  Then, as shown in FIG. 1, an enlarged diameter portion space 5S having a bent surface with a mountain fold line 9b as a bent portion is formed in the enlarged diameter portion 5b. The bent portion of the enlarged diameter portion space 5S is disposed at a position farthest from the outer peripheral surface of the tip member 2.

The ring 5 a is a portion that extends from the distal end side of the four divided portions 7 to the distal end edge 5 f of the holding portion 5. In the present embodiment, the inner diameter H of the ring 5a is larger than the inner diameter h of the connecting portion 5c. And the front-end | tip part outer peripheral surface of the front-end | tip member 2 is set so that it may arrange | position smoothly in the ring 5a.
In the present embodiment, even if the inner diameter H of the ring 5a is set to the same size as the inner diameter h of the connecting portion 5c, the same effect can be obtained.
And the front-end edge 5f of the ring 5a is a contact surface which can contact a biological mucous membrane. That is, in the state in which the distal end surface 2f is in contact with the biological mucous membrane in the observation state, the distal edge 5f is also in contact with the biological mucous membrane.

  According to the configuration in which the divided portion 7 is provided and the four divided pieces 6 are arranged in the circumferential direction in the middle portion, the tip edge 5f of the ring 5a is moved in the axial direction as indicated by a broken line arrow Y3A in FIG. When the compressive force in the central axis direction is applied, the tip edge 5f of the ring 5a and the tip surface 2f of the tip member 2 gradually approach each other. As a result, the bent portion is bent along the mountain fold line 9b, and the bent angle θ of the bent portion gradually decreases. Then, the second bent portion 8b is gradually separated from the central axis 2a which is the longitudinal axis of the hard portion, and the enlarged diameter portion 5b is gradually enlarged in the outer diameter direction to change to a predetermined enlarged diameter state. Go.

  Specifically, the distal end side of the first enlarged diameter portion 5bf is gradually bent along the first valley fold line 9a1, and the proximal end side of the second enlarged diameter portion 5br is along the second valley fold line 9a2. As shown in FIG. 3C, the bending angle θ is gradually changed from an obtuse angle to an acute angle.

Then, in the state where the ring 5a is externally fitted to the outer peripheral surface of the distal end portion of the distal end member 2 as shown by the solid line and the distal end surface 2f and the distal end edge 5f are flush with each other, the enlarged diameter portion 5b is shown in FIG. As shown in FIG. 3B, the second bent portion 8b is separated from the central axis 2a by a predetermined distance, thereby obtaining a predetermined expanded state.
In this expanded diameter state, as shown in FIG. 3A, the vicinity of the second bent portion 8b protrudes from the tip surface 2f and the tip edge 5f to the tip side by the dimension t.

Here, the operation of the magnification observation probe 1 in which the holding portion 5 is provided in the insertion portion 4 will be described.
The magnifying observation probe 1 is inserted into the treatment instrument insertion channel of the endoscope, and performs observation by bringing the observation unit into contact with the biological mucous membrane of the region of interest. For this reason, the surgeon first introduces the insertion portion of the endoscope into the body for observation. Then, if necessary, the magnification observation probe 1 is introduced into the body via the treatment instrument insertion channel 31 of the endoscope 30.

  At this time, in the vicinity of the second bent portion 8b which is the maximum outer diameter portion of the drum shape, the enlarged diameter portion 5b is deformed to a small diameter by contacting the inner surface of the treatment instrument insertion channel 31, and the channel 31 is smoothly formed. Move forward in. Then, as shown in FIG. 4A, the holding portion 5 of the magnification observation probe 1 protrudes from the distal end opening 31 m of the treatment instrument insertion channel 31 into the body.

  At this time, the holding unit 5 is displayed in the endoscopic image displayed on the display device. Thus, the surgeon confirms that the magnification observation probe 1 has been led out into the body. Here, the surgeon adjusts the position so that the divided pieces 6 u colored by rotating the magnification observation probe 1 are displayed in a desired state in the endoscopic image obtained by the high-magnification observation optical system 11. As a result, the upward direction of the magnification observation probe 1 and the upward direction of the endoscope 30 coincide with each other.

  Next, the operator adjusts the position of the endoscope 30 and the position of the holding unit 5 while observing the endoscope image, and advances the ring 5a toward the region of interest 40 as shown in FIG. 4B. The tip edge 5f is brought into contact with the region of interest.

  Next, the surgeon confirms whether or not the ring 5a is arranged at a desired position of the region of interest with an endoscopic image. After the confirmation, the surgeon advances the insertion portion 4 of the magnification observation probe 1 toward the region of interest 40 in a state where the distal edge 5f is in contact with the biological mucous membrane.

  Then, the distal end surface 2f of the distal end member 2 is moved toward the biological mucous membrane, and the distal end edge 5f gradually approaches the distal end surface 2f as described with reference to FIG. 3A. As a result, as described above, the diameter-expanded portion 5b gradually changes to the diameter-expanded state as it moves.

  And the front-end | tip part outer peripheral surface of the front-end | tip member 2 is fitted and arrange | positioned in the inner peripheral surface of the ring 5a, the front-end edge 5f and the front-end | tip surface 2f will be in the state which contacted the biological mucosa, and the enlarged diameter part 5b is desired It changes to the expanded state. As a result, the vicinity of the second bent portion 8b located on the distal end side with respect to the distal end surface 2f and the distal end edge 5f is brought into a contact state in which the biological mucous membrane is pressed.

At this time, the observation window 15 is disposed in close contact with the biological mucous membrane, the distal end surface 2f and the distal edge 5f are disposed in contact with the biological mucous membrane, and each divided piece constituting the enlarged diameter portion 5b. 6 near the second bent portion 8b is separated from the central axis 2a and pressed against the biological mucous membrane.
As a result, the observation window 15 of the magnifying observation probe 1 is placed in close contact in a stable state without being displaced from the biological mucous membrane of the region of interest 40, and good observation can be performed.
When the operator observes the next region of interest, first, the distal edge 5f of the holding unit 5 is separated from the biological mucous membrane. Then, the enlarged diameter portion 5b is restored to the drum shape by the elastic force of each bent portion 8a, 8b, 8c.

  Thereafter, the surgeon performs endoscopic observation with the second enlarged diameter portion 5br of the enlarged diameter portion 5b disposed in the treatment instrument insertion channel 31. Then, when the operator observes a new region of interest, the distal edge 5f is again brought into contact with the biological mucous membrane of the region of interest 40 as described above, the contact position is confirmed, and the distal edge 5f is moved to the distal surface 2f. The observation window 15 is brought into close contact with the biological mucous membrane, the distal end surface 2f and the distal edge 5f are placed in contact with the biological mucous membrane, and the vicinity of the four second bent portions 8b of the enlarged diameter portion 5b is brought into contact with the biological mucous membrane. The region of interest is observed by the magnification observation probe 1.

  After completing the observation of all the regions of interest, the surgeon removes the magnification observation probe 1. At this time, the enlarged diameter portion 5b is restored to the drum shape by separating the tip edge 5f from the biological mucous membrane. When the second bent portion 8b enters the treatment instrument insertion channel 31, the second enlarged diameter portion 5br comes into contact with the inner surface of the channel, and the enlarged diameter portion 5b is deformed to a small diameter, so that the channel can be smoothly formed. Retreats inside 31 and is removed.

  As described above, the enlarged member 5b formed by arranging the four divided pieces 6 having the bent portions 8a, 8b, and 8c in the circumferential direction on the distal end member 2 constituting the insertion portion 4 of the magnification observation probe 1. The holding part 5 provided with is provided. As a result, in the state where the observation window 15 is placed in close contact with the biological mucous membrane, the tip edge 5f is placed in contact with the biological mucous membrane and the second bent portion 8b of each divided piece 6 constituting the enlarged diameter portion 5b. The vicinity is placed in contact with the biological mucous membrane at a predetermined distance from the central axis 2a. As a result, a stable observation state can be obtained.

  Further, by separating the distal end edge 5f of the holding part 5 from the biological mucous membrane, the expanded diameter part 5b is restored to the drum shape by the elastic force of the bent parts 8a, 8b, 8c. Therefore, the surgeon observes a plurality of regions of interest by a procedure for bringing the tip edge 5f into contact with the biological mucous membrane of the region of interest, a procedure for confirming the contact position, and a procedure for bringing the tip edge 5f closer to the tip surface 2f. By performing the procedure of bringing the observation window 15 into close contact with the biological mucous membrane, a stable holding state can be obtained, and a plurality of observations can be easily repeated.

  Further, by making it possible to visually identify the colored divided pieces 6u among the four divided pieces 6, the arrangement position and posture of the magnification observation probe 1 can be easily operated using the colored divided pieces 6u as a guide. You can do what you want.

  Further, when the second bent portion 8b is separated from the central axis 2a by a predetermined distance and the enlarged diameter portion 5b is in a predetermined expanded state, the vicinity of the second bent portion 8b is the tip surface 2f and the distal end. It protrudes from the edge 5f to the tip side by a dimension t. As a result, in addition to the front end surface 2f and the front end edge 5f, the vicinity of the second bent portion 8b of the four divided pieces 6 can be reliably pressed against the biological mucous membrane to obtain a stable holding state.

In addition, the number of the division | segmentation pieces which comprise the enlarged diameter part 5b is set to four. However, the number of divided pieces is not limited to four, and may be more or less as long as similar actions and effects can be obtained.
Moreover, the number of the bending parts provided in the four division pieces 6 is set to three. However, the number of the bent portions is not limited to three, and may be more or less as long as similar actions and effects can be obtained.

  Moreover, you may make it provide a some uneven | corrugated | grooved part in the contact surface which contacts the biological mucous membrane of the four division pieces 6. FIG. By providing a plurality of concave and convex portions on the contact surfaces of the four divided pieces 6, the area in contact with the biological mucous membrane increases, and the enlarged diameter portions 5 b of the four divided pieces 6 are pressed and arranged on the biological mucous membrane in a more stable state. be able to.

  Furthermore, in the above-described embodiment, the connecting portion 5c of the holding portion 5 is integrally fixed to the outer peripheral surface of the proximal end side of the distal end member 2 by adhesion. However, the holding portion 5 is not limited to a configuration in which the holding portion 5 is integrally fixed to the distal end member 2 by bonding. As shown in FIG. 5, the connecting portion 5c of the holding portion 50 and the proximal end side of the distal end member 2A May be integrally fixed by screwing. That is, the holding part 50 may be provided with the female screw 50f and the male screw 2Am may be provided on the proximal end side of the distal end member 2A.

  According to this configuration, after the magnified observation probe 1 is used for observation, the holding portion 50 is removed from the distal end member 2 constituting the insertion portion 4 of the magnified observation probe 1 and discarded, whereby the cleanability of the magnified observation probe 1 is improved. Can be improved.

  The present invention is not limited to the above-described embodiments, and various modifications can be made without departing from the spirit of the invention.

  According to the present invention, it is possible to smoothly insert into and remove from the treatment instrument insertion channel provided in the insertion portion of the endoscope, and in a stable state without displacing the observation window when performing magnified observation. It is possible to realize an enlarged observation probe that can be observed while being in close contact with a region of interest.

  This application is filed on the basis of the priority claim of Japanese Patent Application No. 2014-087565 filed in Japan on April 21, 2014, and the above disclosure is included in the present specification and claims. Shall be quoted.

Claims (5)

In the magnifying observation probe that can be inserted into and removed from the treatment instrument insertion channel provided in the insertion portion of the endoscope,
And the insertion portion for continuously arranged the tip member and the outer tube,
An observation surface provided on the tip member and capable of contacting the biological mucous membrane;
An observation unit for observing the biological mucosa in contact with the observation surface;
An annular portion disposed on the outer peripheral surface of the tip member and disposed in front of the observation surface, and having an inner diameter larger than the outer diameter of the observation surface;
A connecting portion that is provided closer to the base end side than the annular portion and is integrally connected to the base end portion of the tip member;
It consists of a plurality of divided pieces provided in the circumferential direction connecting the annular portion and the connecting portion, and each of the plurality of divided pieces has a predetermined shape in a direction intersecting the longitudinal axis of the tip member. A diameter-enlarged portion having a plurality of bent portions that are deformed and expanded in the outer diameter direction of the outer peripheral surface, respectively, and the annular portion is movable to the base end side;
Among the plurality of divided pieces, provided in one divided piece at a position corresponding to one of the vertical directions in the image observed by the observation unit, and the one divided piece is used as an observation image of the endoscope. An identification unit that can be identified by
A magnified observation probe comprising: The plurality of bent portions are
A first bent portion formed on the base end side of the annular portion of the divided piece, a second bent portion formed in the middle portion of the divided piece, and a distal end side of the connecting portion of the divided piece The magnifying observation probe according to claim 1, wherein the magnifying observation probe is a third bent portion.   In the enlarged observation state in which the observation surface is in contact with the biological mucous membrane, the vicinity of the second bent portion in each of the divided pieces is in contact with the biological mucous membrane in a state of being positioned in front of the annular portion. The magnification observation probe according to claim 2.   The magnification observation probe according to claim 1, wherein the connecting portion is detachable from the tip member. The magnification observation probe according to claim 1, wherein the plurality of divided pieces have a plurality of concave and convex portions on a contact surface that contacts the biological mucous membrane .

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