JP2002204773A - Television camera for observing celom - Google Patents

Abstract

PROBLEM TO BE SOLVED: To secure smoothness and reliability of operation by assistance of hands by minimizing the number of trocars inserted into the celom. SOLUTION: A television camera 14 has a camera body 15 and a flexible cord 16, and in the camera body 15, a housing 26 in which an observation means made up of an object optical system 20 and a solid-state imaging device 21, a lighting means having a light guide 28 are mounted is spherically jointed to a casing 27, and by controlling a control wire 33, an observer can be changed. A fastening portion 37 is attached to the casing 27, the fastening portion 37 has an elastic ring porting 38, and a tapped hole 39 is provided in the inside of the elastic ring 38. The elastic ring portion 38 can be fixed to the outside of a trocar 10 in a state of being embraced, and by threading the tapped portion 40a at the tip of a mounting shaft 40 inserted into a trocar 11 into a tapped hole 39 provided in the fastening portion 37, the camera body 15 can be fixed to the mounting shaft 40.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a television camera for observing the inside of a body cavity, which is inserted into the body cavity by an operator's hand, for example, in the abdominal cavity.

[0002]

2. Description of the Related Art In general, endoscopes used for medical purposes include an endoscope for an upper gastrointestinal tract, which is inserted into a body cavity from an oral cavity, and an endoscope for a lower gastrointestinal tract, which is inserted from an anus. Although used, endoscopes that are further inserted percutaneously have become widespread. Here, the examination and treatment performed using a percutaneously inserted endoscope do not require a large-scale operation such as laparotomy, and can directly perform treatment such as excision of the affected part. In recent years, advances in this type of technique have been remarkable.

[0003] Fig. 8 shows an example of a state in which an examination or treatment using a laparoscope is performed as an example of an endoscope inserted percutaneously. In the figure, reference numeral 1 denotes a laparoscope, which is guided into the abdominal cavity by using a trocar 2 inserted from the body epidermis as a guide. Therefore, the insertion portion 1a of the laparoscope 1 is inserted into the trocar 2 which penetrates the abdominal wall. At the distal end of the insertion portion 1a of the laparoscope 1, there are provided illumination means for illuminating at least the inside of the body cavity, and observation means for observing the inside of the body cavity under illumination by the illumination means. The laparoscope 1 is mainly used for observing the inside of a body cavity, and generally does not include a path for inserting a treatment tool such as forceps, that is, a treatment tool insertion channel.

[0004] As described above, the laparoscope 1 usually does not have a treatment instrument insertion channel, but when an affected part is found as a result of endoscopic examination or the like, sampling of tissue cells is necessary. In such cases, in order to introduce a treatment tool including forceps and a high-frequency treatment tool into the abdominal cavity,
In addition to the trocar 2 into which the insertion portion 1a of the laparoscope 1 is inserted, one or more trocars 3 (1
Book trocar 3) is inserted into the abdominal cavity from the abdominal wall. Then, a predetermined treatment tool 4 is inserted into the other trocar 3.

[0005] In performing the above-described intraperitoneal treatment, it is necessary to minimize damage to healthy tissue cells. For this purpose, the outer diameters of the trocars 2 and 3 inserted into the abdominal wall are minimized. Here, the one having the largest outer diameter to be inserted into the trocar is usually the insertion portion 1a of the laparoscope 1. On the other hand, the treatment tool guided into the abdominal cavity via the trocar becomes small. Moreover, since the operation of the treatment tool must be performed remotely from outside the body,
The operability is poor, and it becomes extremely difficult to perform, for example, an operation of moving a large organ or a delicate operation, for example, an operation of removing an affected part located near a blood vessel.

In view of the above, in recent years, by incising the body epidermis by a predetermined length and inserting the surgeon's hand into the abdominal cavity from the incised portion, it is possible to directly touch the organ by hand. The so-called hand-assisting method of gripping has been practiced clinically. here,
In performing hand assist, the surgeon needs to monitor with an endoscope because he or she cannot directly observe the hand or the surrounding area where the hand is inserted. As described above, since the laparoscope is inserted into the body cavity via the trocar, the operation is usually performed using the video taken by the laparoscope as a key.

In this regard, an endoscope used for hand assist, that is, a television camera for observing in a body cavity, has been developed and put into practical use. This TV camera is
A camera body incorporating at least an observation means in a body cavity including a solid-state imaging means and an illumination means including a light guide in a casing, and a cable and a light guide connected to the camera body and connected to the solid-state imaging means were inserted. The other end of the flexible cord is a connector portion detachably connected to the video signal processing device and the light source device.

[0008]

The endoscope for hand assist described above is generally provided with its camera body connected to surgical gloves or the like and fixed to a finger. Therefore, in a state where the hand is inserted into the body cavity, at least the finger on which the camera body is mounted cannot be used, so that the movement of the finger is greatly restricted. As a result, the operation by the hand assist is greatly restricted.

Since the laparoscope is inserted into the body cavity through the trocar, a predetermined operation can be performed with the hand inserted into the body cavity by observing the image of the laparoscope. However, in this case, the trocar through which the laparoscope has been inserted cannot be used for other purposes, and if it is necessary to operate multiple treatment tools at the same time in performing the treatment, The number of trocars that can insert the number of treatment tools must be inserted into the body cavity,
For this reason, there is a problem that damage to healthy tissue is increased by that much.

The present invention has been made in view of the above points, and an object of the present invention is to minimize the number of trocars to be inserted into a body cavity, and to achieve smooth and reliable operation by hand assist. Is to ensure the quality.

[0011]

SUMMARY OF THE INVENTION In order to achieve the above-mentioned object, the present invention provides a camera body having at least a solid-state imaging means mounted in a casing, and a camera body connected to the camera body and having the solid-state imaging means. A flexible cord removably connected to the video signal processing device by inserting a cable from the means, and a fixing removably attached to the camera body and attached to the trocar or an attachment shaft inserted through the trocar. And a part.

Here, in the casing of the camera body,
In addition to the above-described observation means, it is desirable to provide an illumination means at a position close to the observation means. The illuminating means includes an illuminating lens and a light guide provided facing the illuminating lens, and the light guide is configured to be inserted into a cord together with a signal cable. It is desirable that the observation means can change the observation visual field as desired. For this purpose, the observation means may be configured to be adjustable in angle with respect to the casing, that is, to be able to swing. As an example for remotely changing the field of view by adjusting the angle of the observation means, the observation means is mounted on a casing via a spherical bearing, and an operation wire inserted through a flexible cord is used. The observation means can be directed in a desired direction by the push-pull operation. As the configuration of the fastening part provided in the camera body,
Although it depends on the member to be attached, it can be constituted by an elastic ring that engages with the outer surface of the trocar, for example, and a screw portion is provided at the tip of an attachment shaft inserted into the trocar, and the casing of the camera body is It is possible to use a screw hole screwed into the screw portion of the mounting shaft as a fastening portion.

[0013]

Embodiments of the present invention will be described below with reference to the drawings. FIG. 1 shows a state in which an intraabdominal examination, treatment, and the like are performed using a hand assist technique. The television camera for observing the body cavity of the present invention is not limited to the abdominal cavity. Applicable.

In FIG. 1, reference numerals 10 and 11 denote trocars, 12 denotes a laparoscope, and 13 denotes a treatment tool. The trocars 10 and 11 are stabbed from the body epidermis S into the abdominal cavity C, thereby securing an insertion passage into the abdominal cavity C. The laparoscope 12 is inserted into the main body operation section 12a.
The insertion portion 12b is inserted into the body cavity using the trocar 10 as a guide. Also,
The treatment tool 13 includes, for example, forceps and a high-frequency treatment tool,
The trocar 11 is inserted into the abdominal cavity C via the trocar 11, and treatments such as collection of a tissue sample, excision of an affected part, and coagulation are performed.

An incision of a predetermined width is made in the body epidermis S, and the operator's hand H is inserted through this incision.
When the hand H is inserted into the abdominal cavity C in this manner, the television camera 14 for body cavity observation is carried. As shown in FIG. 2, the television camera 14 includes a camera body 15, a flexible cord 16 connected to the camera body 15, an operation unit 17 connected to the flexible cord 16, A connector 18a is provided at the end of the connection cord 18 so as to be detachably connected to the control unit 19.

FIG. 3 shows a cross section of the camera body 15. In these drawings, reference numeral 20 denotes an objective optical system provided in a lens barrel 20a, and a solid-state imaging device 21 is provided at an image forming position of the objective optical system 20. Attached to. These objective optical systems 2
A television camera as an observation means is constituted by 0 and the solid-state imaging device 21 and the like. A lens barrel 20a constituting the objective optical system 20 is mounted on the holding cylinder 23 so as to be position-adjustable in the optical axis direction. Further, a cover glass 25 mounted on a holder 24 is provided in front of the objective optical system 20. Have been. The solid-state imaging device 21, the holding cylinder 23, and the holder 24 are provided in a housing 26 having an outer peripheral surface 26S having a spherical shape. The housing 26 slides on an inner peripheral surface 27S of a casing 27 having a concave spherical shape. Mounted as possible. Therefore, the angle of the housing 26 with respect to the casing 27 can be adjusted.

Further, a light guide 28 constituting illumination means is provided in the housing 26, and the light guide 28 is made of an optical fiber bundle, and is inserted into a through hole 26a provided in the housing 26. The front end surface serves as an emission part for illumination light. The light guide 28 includes two light guides 28 and is disposed at positions on both sides of the objective optical system 20. A protective glass 29 is fitted between the inner peripheral portion of the housing 26 and the outer peripheral portion of the holder 24 to which the cover glass 25 is attached.
The position where the light emitting portion of the light guide 28 faces is a divergent lens portion 29a.

A predetermined number of wirings are connected to a circuit board 22 to which the solid-state imaging device 21 is connected. These wirings are bundled as a signal cable 30 and
6, extending into the casing 27 from the proximal opening 26b,
Further, it is inserted into the flexible cord 16. Further, a light guide 28 having a distal end branched into two extends from the base end opening 26b into the casing 27, is integrated into the casing 27, and is separated from the casing 27 into the flexible cord 16. Has been inserted. The signal cable 30 and the light guide 27 extend from the flexible cord 16 through the operation unit 17 into the connection cord 18, and are connected to the control unit 19 via the connector 18a. Therefore, the control unit 19 includes a light source section facing the incident end of the light guide 27 and a video signal processing circuit to which the signal cable 30 is connected.

As described above, the housing 26 and the casing 2 on which the observation means including the objective optical system 20 and the solid-state image sensor 21 and the illumination means including the light guide 28 are mounted.
The joint with the lens 7 has a spherical shape, so that the housing 26 can rotate in an arbitrary direction, whereby the field of view of the observation means can be directed in a desired direction. The change of the observation visual field by this observation means can be performed by operating knobs 31a and 31b provided on the operation unit 17 (FIG. 2).
) Is operated remotely. For this purpose, as shown in FIG. 4, pulleys 32a, 32b are provided on both operation knobs 31a, 31b, respectively.
Are connected to each other, and a pair of operation wires 33 are wound around each of the pulleys 32a and 32b. 4
The operation wire 33 made of a book is inserted into the close contact coil 34 in the flexible cord 16.
4 is fixed to a mounting plate 35 provided in the casing 27. A cross arm 36 is attached to the base end of the housing 26. The cross arm 36 extends over every 90 °. The four operation wires 33 are led out from the tip of the close contact coil 34, and each arm of the cross arm 36 is Piece 36
U, 36D, 36R, 36L.

For example, the other ends of the two operation wires 33 wound around the pulley 32a of the operation knob 31a are connected to arm pieces 36U and 36D of the cross arm 36, respectively, and wound around the pulley 32b of the operation knob 31b. The other ends of the two operation wires 33 are connected to arm pieces 36R and 36L, respectively. Thus, when the operation knob 31a is turned in the forward and reverse directions, the housing 26 turns vertically with respect to the casing 27, and when the operation knob 31b is turned in the forward and reverse directions, the housing 26 turns right and left. When the operation knobs 31a and 31b are operated in combination, the housing 26 rotates in an arbitrary direction. As a result, the observation visual field of the observation means including the objective optical system 20 and the solid-state imaging device 21 provided in the housing 26 can be changed in an arbitrary direction.

Here, as is apparent from FIG. 3, the casing 27 is connected to a substantially cylindrical main body 27a and the base end side of the main body 27a, and the distal end of the flexible cord 16 is fixed. The connecting portion 27b is connected to the distal end side of the main body 27a, and the housing 26 is connected together with the main body 27a.
And a locking portion 27c whose outer surface is spherically joined. Then, on the outer surface of the main body 27a, FIG.
As shown in the figure, the fastening portion 37 is attached. The fastening portion 37 has an elastic ring portion 38 made of a substantially C-shaped elastic plate piece, and a screw hole 39 is provided on an inner surface of the elastic ring portion 38. As described below,
The elastic ring portion 38 can be detachably fastened so as to hold the outer surface of the trocar 10, and the screw hole 39 is screwed into a screw portion 40 a provided at the tip of the mounting shaft 40, whereby the mounting shaft It can be detachably attached to 40.

The television camera 14 for observing the inside of the body cavity is constructed as described above. The television camera 14 is used by the surgeon's hand H at the time of examination, treatment, treatment and the like of the abdominal cavity performed by hand assist. Can be carried at the time of insertion into the abdominal cavity C. As is clear from FIG. 1, the laparoscope 1 is provided inside the abdominal cavity C by trocars 10 and 11 from the outside.
A path for inserting the treatment instrument 2 and the treatment tool 13 is ensured. Therefore, at least the laparoscope 12 is inserted into the trocar 10 so that the inside of the abdominal cavity C can be observed. Thereby, the state inside the abdominal cavity C can be observed from the stage before the operator's hand H is inserted, and the safety of the operation is ensured.

The hand inserted into the abdominal cavity C holds the camera body 15 of the television camera 14, and the camera body 15 can observe the inside of the abdominal cavity C by itself. By moving the observation field of view of the camera body 15 to a site of interest while moving the
The inside and the organs of the can be examined more closely. However, since the camera body 15 is gripped, hand movement is restricted. Therefore, if necessary, as shown in FIG. 5, by fixing the elastic ring portion 38 constituting the fastening portion 37 provided on the camera body 15 so as to hold the elastic ring portion 38 on the outer surface of the trocar 10, The hand can be released from the camera body 15. Further, as shown in FIG. 6, a mounting shaft 40 provided with a screw portion 40a at the tip is inserted into the other trocar 11, and the tip of the mounting shaft 40 is screwed into a fastening portion 37 of the camera body 15. 3
By screwing the camera body 9 into the camera body 9, the camera body 15 can be fixed to the mounting shaft 40, and the hands for performing the hand assist can also be freely set.

As described above, when the camera body 15 is fixed to the outer surface of the trocar 10 or the mounting shaft 40 inserted into the trocar 11, the abdominal cavity C is
You can observe inside. Moreover, the camera body 15 can direct the observation visual field in an arbitrary direction by operating the operation knobs 31a and 31b provided on the operation unit 17 located outside the body. Also, the camera body 1 is attached to the mounting shaft 40.
When the camera 5 is mounted, the observation field of view can be changed by rotating the mounting shaft 40 about the axis in the trocar 11. As a result, it is not necessary to observe the inside of the abdominal cavity C with the laparoscope 12 inserted into the trocar 10, and the laparoscope 12 can be extracted. Therefore, the trocar 10 can be used as a guide for other members.

Since the trocar 10 into which the laparoscope 12 is inserted has a large inner diameter, a treatment tool such as a large forceps 41 can be inserted as shown in FIG. 5, for example. As a result, treatment and treatment inside the abdominal cavity C can be performed more smoothly. Moreover,
By using the trocar 10 as an insertion path for the treatment tool, the number of trocars to be inserted can be reduced, and damage to healthy tissue is minimized. In addition, since the hand for performing the hand assist is completely released, the hand can be freely moved, and the organ can be gripped in the abdominal cavity C.
Procedures and the like that require delicate and careful operation can be performed smoothly and reliably.

When the hand is taken out of the abdominal cavity C, the camera body 15 fixed to the trocar 10 or the mounting shaft 40 is detached, and the camera body 15 is grasped by hand. It will be taken out.

It is sufficient that the camera body of the television camera is provided with at least the observation means including the objective optical system and the solid-state image pickup device, and it is not necessary to mount the illumination means. However, since it is necessary to illuminate the inside of the body cavity because it is a dark place, the illuminating means may be configured to be guided into the body cavity directly or through another trocar, and the visual field of the observation means can be changed. For example, when the camera body is fixed to a trocar having a so-called angle mechanism that can bend the tip portion in an arbitrary direction, the angle of the observation unit with respect to the camera body may not be changed.

Further, in the case where the housing in which the observation means is mounted can be rotated with respect to the casing of the camera body, for example, a configuration as shown in FIG. 7 can be adopted. In this figure, the same or equivalent members as those in FIG. 3 and the like are denoted by the same reference numerals. The configuration of the visual field changing mechanism shown in FIG.
A mounting ring 50 is screwed to the base end of the housing 26, and the distal end of the operation wire 51 is connected to the mounting ring 50 (in FIG. 9, the two operation wires 51 are connected. Another two operation wires can be connected to the left and right). The operation wire 51 is once extended obliquely forward, is engaged with a direction changing guide portion 52 provided on the inner surface of the casing 27, and extends rearward from the guide portion 52. Further, a mounting portion 53 is provided at a rear position of the guide portion 52 provided on the casing 27, and a base 54 a provided at the tip of the close contact coil 54 is fixed to the mounting portion 53. The operation wire 51 whose direction has been changed by the guide portion 52 is connected to the base 54a.
From the contact coil 54.
Therefore, two to four operation wires 51 are individually inserted into the close contact coil 54 and extend to the operation unit.

According to this structure, a force for turning the spherical joint between the housing 26 and the casing 27 in a substantially tangential direction can be exerted. Can be performed with a light load on the casing 27, and the rotation angle with respect to the operation amount of the operation knob can be made large, so that the operability of the operation of changing the observation field of view is further improved.

Here, the housing 26 has a casing 27
To prevent dirt from adhering to this sliding portion, the housing
The sealing member 55 made of a cylindrical elastic film can be applied to the portion 7.

[0031]

Since the present invention is constructed as described above, the number of trocars inserted into the body cavity can be minimized, and the smoothness and certainty of the operation by hand assist can be ensured. To play.

[Brief description of the drawings]

FIG. 1 illustrates one embodiment of the present invention, and is an explanatory diagram of a state in which an examination and treatment in an abdominal cavity are performed using a hand assist technique.

FIG. 2 is an overall configuration diagram showing one embodiment of a television camera for observing the body cavity according to the present invention.

FIG. 3 is a sectional view of a main part of the television camera of FIG. 2;

FIG. 4 is a configuration explanatory view of a visual field changing mechanism of an observation unit of the television camera.

FIG. 5 is an explanatory diagram showing a state where the camera body is detachably fixed to the trocar.

FIG. 6 is a configuration explanatory view showing a state where the camera body is mounted on a mounting shaft.

FIG. 7 is an essential part cross-sectional view of a television camera showing a second embodiment of the present invention.

FIG. 8 is a configuration explanatory view showing a state in which an inspection or treatment using a laparoscope is performed as a general percutaneously inserted endoscope.

DESCRIPTION OF SYMBOLS 10, 11 trocar 12 laparoscope 13 treatment tool 14 TV camera 15 camera body 16 flexible cord 17 operation unit 18 connection cord 19 control unit 20 objective optical system 21 solid-state imaging device 26 housing 27 casing 31a, 31b Operation knob 33, 51 Operation wire 34, 54 Close contact coil 37 Fastening part 38 Elastic ring part 39 Screw hole 40 Mounting shaft 40a Screw part

Claims (6)

[Claims] 1. A camera body having at least a solid-state imaging means mounted in a casing and having an observation means, connected to the camera body and inserted through a cable from the solid-state imaging means to be detachable from a video signal processing device. A television for in-vivo observation, comprising: a flexible cord to be connected; and a fastening portion provided on the camera body and detachably attached to a trocar or an attachment shaft inserted through the trocar. camera. 2. An illumination device is provided in a casing of the camera body at a position close to the observation device, the illumination device includes an illumination lens, and a light guide provided to face the illumination lens. 2. The television camera for observation in a body cavity according to claim 1, wherein the light guide is inserted into the flexible cord. 3. The body cavity observation apparatus according to claim 1, wherein the observation means is configured to be mounted on the casing so as to be adjustable in angle so that the observation field of view can be changed. TV camera. 4. The observation means is mounted on the casing via a spherical bearing, and the observation means is capable of adjusting the angle by remote control of an operation wire inserted into the flexible cord. The television camera for observation in a body cavity according to claim 2 or 3, wherein: 5. The television camera for in-vivo observation according to claim 1, wherein the fastening portion is formed of an elastic ring which is detachably engaged with an outer surface of the trocar. 6. The mounting shaft according to claim 1, wherein a screw portion is provided at a tip of the mounting shaft inserted into the trocar, and the fastening portion is a screw hole screwed into the mounting shaft. Television camera for body cavity observation.