ENDOSCOPE
20210369089 · 2021-12-02
Assignee
Inventors
- Tsuneo FUKUZAWA (Ashigarakami-gun, JP)
- Yasuhiko Morimoto (Ashigarakami-gun, JP)
- Satoru OKADA (Ashigarakami-gun, JP)
Cpc classification
A61B8/12
HUMAN NECESSITIES
G02B23/24
PHYSICS
International classification
A61B1/00
HUMAN NECESSITIES
Abstract
Provided is an endoscope that can fix a guidewire and stably hold a treatment tool. The endoscope includes a distal end body (36) having an elevator housing (62) that opens toward a first direction, a treatment tool lead-out port (80) that opens inside of the elevator housing (62), and an elevator (60) that is provided inside of the elevator housing (62) so as to be rotatable between an elevated position and a lowered position, the elevator (60) having a treatment tool guiding surface (60a). A facing wall portion (66), which is on a proximal end side and an opening part of the elevator housing (62), has a concave surface (96) that is formed on an inner side of the elevator housing (62) and a convex surface (94) that is formed at a position closer than the concave surface (96) to an opening. When the elevator (60) is in a forward position that is on the lowered position side relative to the elevated position, the concave surface (96) and the treatment tool guiding surface (60a) constitute a treatment tool holding portion (99) for holding a treatment tool, and, when the elevator (60) is in the elevated position, the convex surface (94) and the treatment tool guiding surface (60a) constitute a guidewire fixing portion (98) for fixing a guidewire.
Claims
1. An endoscope comprising: a distal end body that is provided at a distal end of an insertion section that extends in a longitudinal axis direction, wherein the distal end body has an elevator housing that opens toward a first direction that is perpendicular to the longitudinal axis direction, a treatment tool lead-out port that opens inside of the elevator housing, and an elevator that is provided inside of the elevator housing so as to be rotatable between an elevated position and a lowered position, the elevator having a treatment tool guiding surface, wherein the elevator housing has a facing wall portion in a part that is on a proximal end side in the longitudinal axis direction and that is an opening part of the elevator housing, wherein the facing wall portion has a concave surface that is formed on an inner side of the elevator housing and a convex surface that is formed at a position closer than the concave surface to an opening, and wherein, when the elevator is in a forward position that is on the lowered position side relative to the elevated position, the concave surface and the treatment tool guiding surface constitute a treatment tool holding portion for holding a treatment tool, and, when the elevator is in the elevated position, the convex surface and the treatment tool guiding surface constitute a guidewire fixing portion for fixing a guidewire.
2. The endoscope according to claim 1, wherein the treatment tool guiding surface has a concave shape, wherein the treatment tool holding portion has a holding space in which the treatment tool is to be held, the holding space being formed between the treatment tool guiding surface and the concave surface in such a way that the treatment tool guiding surface and the concave surface are separated from each other, and wherein the guidewire fixing portion has a fixing space in which the guidewire is to he fixed, the fixing space being formed between the treatment tool guiding surface and the convex surface in such a way that the treatment tool guiding surface and the convex surface are close to each other.
3. The endoscope according to claim 1, wherein, when the facing wall portion is seen from a second direction that is perpendicular to the longitudinal axis direction and that is perpendicular to the first direction, the following expression (1) is satisfied:
θ.sub.1<θ.sub.2 (1), where θ.sub.1 is an angle between the concave surface and a distal end direction of the longitudinal axis direction, and θ.sub.1 is an angle between the convex surface and the distal end direction of the longitudinal axis direction.
4. The endoscope according to claim 3, wherein the following expression (2) is satisfied:
θ.sub.1≤θ.sub.t>θ.sub.2 (2), where θ.sub.t is an male between a lead-out direction of the treatment tool and the distal end direction of the longitudinal axis direction when the elevator is in the forward position.
5. The endoscope according to claim 3, wherein the angle θ.sub.2 and an angle θ.sub.gw satisfy the following expression (3):
θ.sub.2≤θ.sub.gw (3), where θ.sub.gw is an angle between a lead-out direction of the guidewire and the distal end direction of the longitudinal axis direction when the elevator is in the elevated position.
6. The endoscope according to claim 5, wherein the angle θ.sub.gw is less than or equal to 90°.
7. The endoscope according to claim 1, wherein the convex surface and the concave surface are each arc-shaped, and wherein a radius of curvature R.sub.1 of the concave surface is greater than a radius of curvature R.sub.2 of the convex surface.
8. The endoscope according to claim 1, wherein the concave surface is integrally formed with a lead-out port forming wall that forms the treatment tool lead-out port.
9. The endoscope according to claim 1, wherein the treatment tool has a higher bending stiffness than the guidewire.
10. The endoscope according to claim 1, wherein the distal end body has an ultrasonic transducer having an ultrasonic vibrator, and wherein the elevator is disposed on the proximal end side in the longitudinal axis direction relative to the ultrasonic transducer.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0012]
[0013]
[0014]
[0015]
[0016]
[0017]
[0018]
[0019]
[0020]
DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0021] Hereafter, an endoscope according to the present invention will be described with reference to the drawings.
Endoscope
[0022]
[0023] The endoscope 1 in the figure is constituted by an operation section 10 that an operator grips to perform various operations, an insertion section 12 that is inserted into a body cavity of a patient, and a universal cord 14. The endoscope 1 is connected, via the universal cord 14, to system component devices (not shown), such as a processor device and a light source device, that constitute an endoscope system.
[0024] Various operation members, which are operated by an operator, are provided in the operation section 10. For example, an angle knob 16, an elevating operation lever 18, an air/water supply button 20, a suction button 22, and the like are provided.
[0025] In the operation section 10, a treatment tool insertion port 24, for inserting a treatment tool into a treatment tool insertion channel that extends through the insertion section 12, is provided.
[0026] The insertion section 12 extends out from the distal end of the operation section 10, and the entirety of the insertion section 12 has a small-diameter elongated shape.
[0027] The insertion section 12 is constituted by a flexible portion 30, a bending portion 32, and a distal end portion 34, sequentially from the proximal end side toward the distal end side.
[0028] The flexible portion 30 occupies most part of the insertion section 12 from the proximal end side, and has flexibility of bending in any directions. When the insertion section 12 is inserted into a body cavity, the flexible portion 30 bends along an insertion path into the body cavity.
[0029] By rotating the angle knob 16 of the operation section 10, the bending portion 32 can be bent in the up-down direction and in the left-right direction. By bending the bending portion 32, the distal end portion 34 can be directed in a desirable direction,
[0030] The distal end portion 34 includes a distal end body 36. Which will be described below in detail with reference to
[0031] The universal cord 14 illustrated in
First Embodiment
Configuration of Distal End Portion
[0032] Next, the configuration of the distal end portion 34 of the insertion section 12 of the endoscope of the first embodiment will be described.
[0033] The distal end portion 34 has the distal end body 36 that forms an outer wall and an inner partition wall thereof Each component disposed in the distal end body 36 is accommodated and held in a housing portion included in the distal end body 36,
[0034] Although details are omitted, a part of the distal end body 36 is removable as a separate block, and each component can be mounted in a predetermined housing portion in a state in which the separate block is removed. After each component has been mounted in the housing portion, the separate block is attached to the distal end body 36, and thereby each component is accommodated and held in the housing portion and fixed to the distal end portion 34.
[0035] The distal end body 36 is made of an insulating material having insulation ability, the examples of which are plastic resin materials such as a methacrylate resin, a polyphenylsulfone resin, a polyetherimide resin, a polvetheretherketone resin, and polycarbonate.
[0036] As illustrated in
[0037] In the extension portion 42, the ultrasonic transducer 50, which is of a convex type and which transmits and receives ultrasound, is disposed. The ultrasonic transducer 50 has an ultrasound transmitting/receiving surface 52, and the ultrasound transmitting/receiving surface 52 is formed by arranging ultrasonic vibrators in a curved shape in a longitudinal axis 38 direction of the insertion section 12. The ultrasonic transducer 50 obtains data for generating an ultrasound image of a body tissue.
[0038] As illustrated in
[0039] The opening portion 58 is provided in the base portion 40 of the distal end body 36, and a treatment tool is led out from the opening portion 58 to the scanning range of ultrasound of the ultrasonic transducer 50. The periphery of an elevator housing 62 is formed by an elevator housing forming wall 64, and the opening portion 58 is formed so as to open toward a first direction that is perpendicular the longitudinal axis 38 direction of the insertion section 12 of the elevator housing 62.
[0040] As illustrated in
[0041] The elevator 60 is disposed in the elevator housing 62 at a position in front of the treatment tool lead-out port 80. The elevator 60 is rotatable between an elevated position and a lowered position around a rotational axis 92. The elevator 60 is made of a metal material such as a stainless steel, and has a treatment tool guiding surface 60a, which has a concave shape that is upwardly curved from the proximal end side toward the distal end side of the distal end body 36, on the upper surface side thereof. A treatment tool led out from the treatment tool lead-out port 80 is guided along the treatment tool guiding surface 60a upward with respect to the longitudinal axis direction of the insertion section 12, and is led out from the opening portion 58 on the upper side of the elevator housing 62.
[0042] By operating the elevating operation lever 18 illustrated in
[0043] The distal end body 36 has an elevation unit 63, and the elevator 60 is disposed in the elevation unit 63. The elevation unit 63 is made of, for example, an anti-corrosive metal material
[0044] The treatment tool insertion channel 82 illustrated in
[0045] The observation window 44 is disposed in an observation means forming surface 72a provided on the proximal end side of the elevator housing 62. An imaging system unit, in which an image-forming optical system and a solid-state imaging element which constitute an imaging unit are integrally assembled, is accommodated inside of the observation window 44, Thus, when light from a region to be treated, which is in the field of view of the imaging unit, is taken in through the observation window 44, the light passes through the image-forming optical system and forms an observation image in the solid-state imaging element. That is, an image of the region to be treated is captured by the solid-state imaging element.
[0046] The first illumination window 46A and the second illumination window 46B are provided in illumination means forming surfaces 72b and 72c. A light emission portion that constitutes an illumination unit is accommodated inside of each of the first illumination window 46A and the second illumination window 46B. From the light emission portion, illuminan on light that is transmitted via a light guide from the light source device connected to the universal cord 14 is emitted. A region to be treated, which is in the field of view of the imaging unit, is irradiated with the illumination light via the first illumination window 46A and the second illumination window 46B.
[0047] The air/water supply nozzle 48 is provided in a nozzle forming surface 72d. By operating the air/water supply button 20 shown in FIG. 1, a cleaning liquid, water, air, or the like is ejected toward the observation window 44 from the air/water supply nozzle 48 shown in
[0048] Next, the positional relationship among the opening portion 58, the elevator housing 62, and the observation window 44 will be described. As illustrated in
[0049] Regarding the positions of the observation window 44 and the elevator housing 62 in a second direction indicated by an arrow B in
[0050] The distal end body 36 is formed by mounting the elevation unit 63 made of a metal into a body case 37 made of a resin. A part of the elevator housing 62 is constituted by the body case 37, and the other part of the elevator housing 62 is constituted by the elevation unit 63.
[0051] The treatment tool lead-out port 80, which opens inside of the elevator housing 62, is provided in the elevation unit 63. The treatment tool lead-out port 80 is formed by a lead-out port forming wall 86 provided therearound, and is connected to the distal end of the treatment tool insertion channel 82. That is, the distal end of the treatment tool insertion channel 82 is connected to the elevation unit 63 and a treatment tool that is inserted through the inside of the treatment tool insertion channel 82 passes through the lead-out port forming wall 86 and the treatment tool lead-out port 80 and is led out to the elevator housing 62.
[0052] The elevator housing forming wall 64, which is on the proximal end side in the longitudinal axis direction of the elevator housing 62, has a facing wall portion 66 in a part of the opening portion 58. The facing wall portion 66 has a convex portion 68 that protrudes toward the distal end side in the longitudinal axis 38 direction. The convex portion 68 has a concave surface 96 (see
[0053]
[0054] As illustrated in
[0055] in a state in which the elevator 60 is in the elevated position, the width of the gap between the treatment tool guiding surface 60a and the convex surface 94 is preferably less than or equal to 0.5 mm. Because the diameter of a general guidewire is 0.6 mm, by making the width of the gap less than or equal to 0.5 mm, it is possible to hold the guidewire between the convex portion 68 and the treatment tool guiding surface 60a.
[0056] The concave surface 96 is formed on the elevator housing 62 side of the convex portion 68 of the facing wall portion 66. As illustrated in
[0057] The expression “a state in which the elevator is in a forward position that is on the lowered position side relative to the elevated position” means the maximally elevated position when the treatment tool 88 is held by the treatment tool guiding surface 60a. It may not be possible to move the elevator 60 to the elevated position in a state in which the treatment tool 88 is held, because the treatment tool 88 has a larger diameter and a higher bending stiffness than the guidewire 90. It is possible to move the elevator 60 to the elevated position in a state in which the treatment tool 88 is held, because the guidewire 90 has a smaller diameter and a lower bending stiffness than the treatment tool 88.
Relationship among Convex Surface, Concave Surface, and Lead-Out Direction of Treatment Tool
[0058] Referring to
[0059] As illustrated in
θ.sub.1<θ.sub.2 (1)
[0060] As illustrated in Pigs. 5 and 7, preferably, the following expressions (2) and (3) are satisfied, where θ.sub.t is the angle between the lead-out direction of the treatment tool 88 and the distal end direction of the longitudinal axis 38 direction when the elevator 60 is in the forward position that is on the lowered position side relative to the elevated position, and θ.sub.gw is the angle between the lead-out direction of the guidewire 90 and the distal end direction of the longitudinal axis 38 direction when the elevator 60 is in the elevated position.
θ.sub.1≤θ.sub.t<θ.sub.2 (2)
θ.sub.2≤θ.sub.gw (3)
[0061] The lead-out direction of the treatment tool 88 led out from the treatment tool lead-out port 80 is adjusted by the elevator 60. When θ.sub.1≤θ.sub.t is satisfied, it is possible to bring the treatment tool 88 into contact with the concave surface 96 to form a fulcrum for changing the lead-out direction. Thus, it is possible to stably hold the treatment tool 88 by using the treatment tool guiding surface 60a and the concave surface 96.
[0062] When θ.sub.t<θ.sub.2 is satisfied, it is possible to prevent the treatment tool 88 from coming into contact with the convex surface 94 and to prevent the lead-out direction of the treatment tool 88 from being changed. When θ.sub.2≤θ.sub.gw is satisfied, it is possible to bring the guidewire 90 led out from the opening portion 58 into contact with the convex surface 94 and to reliably fix the guidewire 90 by using the treatment tool guiding surface 60a and the convex surface 94.
[0063] Preferably, the angle θ.sub.gw is less than or equal to 90°. When the angle is less than or equal to 90°, in an operation of pulling out the treatment tool while leaving the guidewire, when the treatment tool 88 is pulled out, it is possible to reduce the reaction (movement) of the guidewire 90 before the guidewire 90 is fixed by the guidewire fixing portion 98. Thus, it is possible to prevent the guidewire 90 from being removed from the penetration point.
[0064] Referring back to
[0065] As described above, with the present embodiment, the facing wall portion 66 of the elevator housing 62 has the convex surface 94 provided at the opening position of the elevator housing 62 and the concave surface 96 provided on the inner side of the elevator housing 62 relative to the convex surface 94, the concave surface 96 and the treatment tool guiding surface 60a constitute the treatment tool holding portion 99, and the convex surface 94 and the treatment tool guiding surface 60a constitute the guidewire fixing portion 98. Thus, it is possible to reliably fix the guidewire 90 by using the guidewire fixing portion 98, and, by holding the treatment tool 88 by using the treatment tool holding portion 99, it is possible to stably lead out the treatment tool 88 from the opening portion 58 without allowing a horizontal wobble.
Second Embodiment
[0066]
[0067] Also when the lead-out port forming wall 186 and the concave surface 196 are integrally formed at the same angle, it is possible to hold the treatment tool by using the concave surface 196 and the treatment tool guiding surface 60a, to prevent a horizontal wobble of the treatment tool, and to stably hold the treatment tool,
[0068] Also in the distal end portion 134 of the endoscope of the second embodiment, when the angle θ.sub.1 between the concave surface 196 and the distal end direction of the longitudinal axis 38 direction satisfies the conditions of the expressions (1) to (3) described above, advantageous effects that are the same as those of the endoscope of the first embodiment can be obtained.
[0069] In the foregoing description, a convex-type ultrasonic transducer has been described, However, the present invention is not limited to a convex-type ultrasonic transducer, and can be applied also to a radial-type ultrasonic transducer.
REFERENCE SIGNS LIST
[0070] 1 endoscope
[0071] 10 operation section
[0072] 12 insertion section
[0073] 14 universal cord
[0074] 16 angle knob
[0075] 18 elevating operation lever
[0076] 20 air/water supply button
[0077] 22 suction button
[0078] 24 treatment tool insertion port
[0079] 30 flexible portion
[0080] 32 bending portion
[0081] 34, 134 distal end portion
[0082] 36 distal end body
[0083] 37 body case
[0084] 38 longitudinal axis of insertion section
[0085] 40 base portion
[0086] 42 extension portion
[0087] 44 observation window
[0088] 46A first illumination window
[0089] 46B second illumination window
[0090] 48 air/water supply nozzle
[0091] 50 ultrasonic transducer
[0092] 52 ultrasound transmitting/receiving surface
[0093] 58 opening portion
[0094] 60 elevator
[0095] 60a treatment tool guiding surface
[0096] 62 elevator housing
[0097] 63 elevation unit
[0098] 64 elevator housing forming wall
[0099] 66 facing wall portion
[0100] 68 convex portion
[0101] 72a observation means forming surface
[0102] 72b, 72c illumination means forming; surface
[0103] 72d nozzle forming surface
[0104] 80 treatment tool lead-out port
[0105] 82 treatment tool insertion channel
[0106] 84 treatment tool lead-out portion
[0107] 86, 186 lead-out port forming wall
[0108] 88 treatment tool
[0109] 90 guidewire
[0110] 92 rotation axis
[0111] 94 convex surface
[0112] 96, 196 concave surface
[0113] 98 guidewire fixing portion
[0114] 99 treatment tool holding portion