JP2004358024A - Endoscope anchor remote guidance system and endoscope treatment method using anchor remote guidance system - Google Patents

Abstract

An endoscopic anchor remote guide that enables an operator to accurately grasp the position of an anchor by viewing an endoscopic observation image even if bleeding occurs from an object and blood adheres to the anchor. An endoscopic treatment method using an anchor remote guidance system is provided.
A gripping member for gripping a target portion inside an object, a magnetic anchor made of a magnetic material connected to the gripping member, and a magnetic field arranged outside the object to generate a magnetic field to power the magnetic anchor And a magnetic anchor guiding device, which gives power to the magnetic anchor by a magnetic field generated by the magnetic anchor guiding device, and lifts the target portion gripped by the gripping member. An endoscope anchor remote guidance system, wherein the surface of the magnetic anchor is colored in a Munsell hue circle in any one of colors ranging from 5GY to 5B.
[Selection diagram] FIG.

Description

[0001]
【Technical field】
The present invention relates to a remote guide system for an endoscope and a treatment method using an endoscope using the remote guide system for an anchor, which are used when a lesion is resected under endoscopic observation.
[0002]
[Prior art and its problems]
Conventionally, in the case of excision of a lesion inside the human body in a normal operation, the distance between the lesion and the adjacent normal tissue is increased by lifting the lesion using grasping forceps, and in that state, the lesion and the normal tissue are removed. Has been removed between. However, for example, in endoscopic mucosal resection (EMR), only one endoscope can be inserted into the body, so that the lesion cannot be lifted. The lesion was lifted by injecting water or the like, and in that state, resection between the lesion and normal mucosa was performed using a high-frequency knife or a snare.
[0003]
However, in such a conventional method, the lesion cannot be lifted to a sufficient position, so that a resection at the boundary between the lesion and normal tissue cannot be sufficiently secured.
Also, when the lesion has a flat shape, it may not be possible to create a resected portion.
[0004]
Furthermore, during the resection operation, the already resected lesion may fall on the normal tissue, thereby obstructing the endoscope's field of view, particularly when the lesion is large. Because of this, the resected part cannot be seen, and the normal part is damaged to perform a blind resection, resulting in complications such as perforation, damage to blood vessels, and major bleeding. Serious complications may occur due to inability to confirm and prevent hemostasis, and safer devices and treatment methods have been required.
[0005]
In order to solve these problems, the present applicant has developed a clip for grasping a lesion inside a human body, a magnetic anchor made of a magnetic material connected to the clip, and a magnetic field generated outside the human body. A magnetic anchor guiding device that powers the magnetic anchor by applying power to the magnetic anchor by a magnetic field generated by the magnetic anchor guiding device to lift the lesion grasped by the clip A remote guidance system has been proposed and a patent application has been filed (Japanese Patent Application No. 2002-268239).
[0006]
The magnetic anchor used in this patent application is formed of, for example, magnetic stainless steel, but the magnetic stainless steel itself has a color that is difficult to distinguish from blood.
Therefore, during the procedure, bleeding occurs from the lesion and its surroundings, and if the blood adheres to the magnetic anchor, the surgeon sees the endoscopic observation image and the magnetic anchor and the lesion with the blood adhered to the magnetic anchor. It will be difficult to distinguish it from the surrounding area. For this reason, it becomes difficult for the surgeon to grasp the position of the magnetic anchor, and as a result, it becomes difficult to lift the lesion in a desired direction.
[0007]
[Object of the invention]
It is an object of the present invention for an endoscope to allow an operator to accurately grasp the position of an anchor by viewing an endoscopic observation image even when bleeding occurs from an object and blood adheres to the anchor. It is an object of the present invention to provide an anchor remote guidance system and a treatment method using an endoscope using the anchor remote guidance system.
[0008]
Summary of the Invention
The endoscope anchor remote guidance system of the present invention is a gripping member that grips a target portion inside a target object, a magnetic anchor made of a magnetic material connected to the gripping member, and a magnetic field disposed outside the target object, A magnetic anchor guide device that generates and powers the magnetic anchor, and powers the magnetic anchor by a magnetic field generated by the magnetic anchor guide device to lift the target portion gripped by the grip member In the anchor remote guiding system for an endoscope, the surface of the magnetic anchor is colored to any one of colors ranging from 5GY to 5B in a Munsell hue circle. Since human blood is red, if the magnetic anchor is colored like this, even if blood adheres to the magnetic anchor, the surgeon can accurately grasp the position of the magnetic anchor and move it in the desired direction Becomes possible.
[0009]
It is more preferable that the color of the surface of the magnetic anchor be any color whose hue is in the range of 10 G to 10 GY in the Munsell hue circle.
[0010]
It is practical to connect the magnetic anchor and the gripping member with a flexible connecting string.
[0011]
It is preferable that the connecting string be colored to any color whose hue is in the range of 5GY to 5B on the Munsell hue circle.
[0012]
The magnetic anchor guiding device generates a magnetic force by a generated magnetic field, and moves the magnetic anchor in a predetermined direction by the magnetic force; and a U-shaped member in which the magnetic guiding member is arranged in a specific plane. It is practical to have an in-plane moving mechanism for moving along the frame member, and a one-way moving mechanism for relatively moving the U-shaped frame member in a direction perpendicular to the one plane.
[0013]
According to another aspect, an endoscope anchor remote guidance system of the present invention includes a gripping member that grips a target site inside a target object, and a non-magnetic material connected to the gripping member, and moves according to gravity. A gravity anchor, wherein the gravity anchor moves in the direction of gravity, thereby moving the target portion grasped by the grasping member in the direction of gravity. Is colored in a Munsell hue circle in any color in the range of 5GY to 5B.
[0014]
It is more preferable that the color of the surface of the gravity anchor be any color whose hue is in the range of 10 G to 10 GY in the Munsell hue circle.
[0015]
Further, it is practical that the gravity anchor and the gripping member are connected by a flexible connecting string.
[0016]
It is preferable that the connecting string be colored to any color whose hue is in the range of 5GY to 5B on the Munsell hue circle.
[0017]
The gripping member includes a plurality of openable and closable pieces that can be opened and closed, and a claw portion formed at a tip portion of the openable and closeable piece, which grips the target portion when the openable piece is in a closed state. It is practical.
[0018]
The treatment method using an endoscope using the anchor remote guidance system of the present invention is a magnetic material having a surface colored with any color having a hue in the range of 5GY to 5B in a Munsell hue circle. A step of arranging a connected body of the anchor and the gripping member inside the object, a gripping step of gripping a target portion inside the object by the gripping member, and applying a magnetic field from a magnetic anchor guiding device arranged outside the object. Generating, moving the magnetic anchor by the magnetic field, and lifting the target portion gripped by the gripping member in a predetermined direction.
[0019]
It is practical to connect the gripping member and the magnetic anchor with a flexible connecting string.
[0020]
Further, it is preferable that the connecting string is colored to any color whose hue is in the range of 5GY to 5B on the Munsell hue circle.
[0021]
According to another aspect, an endoscopic procedure using the anchor remote guidance system of the present invention comprises a non-magnetic material, the hue of which is any color in the Munsell hue circle ranging from 5GY to 5B. The step of arranging a connected body of a gravity anchor and a gripping member whose surface is colored inside the object, a gripping step of gripping a target site inside the object by the gripping member, and the gravity anchor according to gravity Moving the target portion gripped by the gripping member in the direction of gravity.
[0022]
More preferably, the color of the surface of the gravity anchor is colored to any color whose hue is in the range of 10 G to 10 GY on the Munsell hue circle.
[0023]
It is practical to color the connecting string to any color whose hue is in the range of 5GY to 5B on the Munsell hue circle.
[0024]
Further, in any aspect, the gripping member includes a plurality of openable and closable pieces that can be opened and closed, and a claw portion formed at a distal end portion of the openable and closable piece. Preferably, the closed state is set, and the step of gripping the target portion with the claw portion is performed.
[0025]
BEST MODE FOR CARRYING OUT THE INVENTION
Hereinafter, a first embodiment of the present invention will be described with reference to FIGS.
The anchor remote guiding system of the present embodiment includes a magnetic anchor device 10 (consisting of a gripping member 11, a magnetic anchor 12, a connecting string 13, a traction separating member 14, and a tubular fastening member 15), and an endoscope of the magnetic anchor device 10. The apparatus comprises an operating device 30 for performing a separating operation from the mirror 20 and the like, and a magnetic anchor guiding device 40 for controlling the suction of the magnetic anchor device 10 outside the body (to exert a magnetic force on the magnetic anchor 12).
[0026]
First, the configuration of the magnetic anchor device 10 will be described with reference to FIGS.
The gripping member 11 having a symmetrical shape is an elastic member formed by bending a metal plate. The gripping member 11 has a C-ring-shaped base 11a with which the ends of both sides thereof come into contact in a free state, and expands while extending forward from the end of the base 11a. A pair of inclined pieces 11b, 11b to be opened, opening and closing pieces 11c, 11c extending in parallel from the tips of both inclined pieces 11b, 11b, and claws extending while inwardly inclining from the tips of the opening and closing pieces 11c, 11c Parts 11d, 11d. Further, an insertion hole 11a1 is formed in the rear end of the base 11a.
[0027]
The magnetic anchor 12 includes a substantially cylindrical front portion 12a, a substantially triangular pyramid-shaped rear portion 12b, and a mounting portion 12c protruding from the rear portion 12b, and is entirely formed of a ferromagnetic material. Specific examples of the ferromagnetic material include magnets such as platinum magnets, rare earth magnets, terbium, dysprosium, and iron alloys in addition to pure iron and iron alloys. Further, a concave portion 12d is provided in the end face of the mounting portion 12c (see FIG. 1).
Further, the entire surface of the magnetic anchor 12 of the present embodiment is colored green (a color whose hue is defined as 5G in the Munsell hue circle).
[0028]
A flexible connecting string 13 is wound around the base 11a of the gripping member 11, and the other end of the connecting string 13 is fixed to a concave portion 12d of the magnetic anchor 12 (see FIG. 1).
[0029]
The towing separation member 14 is a rod-shaped member, and has a pair of insertion pieces 14 a penetrating through the insertion hole 11 a 1 of the gripping member 11 at its tip and engaging with an inner surface of a base 11 a provided at the tip of the insertion piece 14 a. Then, a retaining portion 14b for preventing the insertion piece 14a from falling out of the base 11a is provided. Further, a hook portion 14c is formed at the base end of the towing separation member 14. The traction separating member 14 is formed of a metal material such as plastic or SUS having a relatively low strength, and cuts when receiving a strong force equal to or more than a predetermined cutting force.
[0030]
The cylindrical fastening member 15 shown in FIGS. 1 to 3 whose both ends are open is made of a flexible material. The tubular fastening member 15 is provided with a pair of slits 15a facing in the same direction as the tubular fastening member 15. The front end of the slit 15a is open and the rear end is closed. Further, the inner diameter of the tubular fastening member 15 is such that the base 11a of the gripping member 11 and the inclined piece 11b can be fitted.
[0031]
From the state shown in FIG. 1 (the state in which the gripping member 11 is not fitted in the cylindrical tightening member 15), when the traction separation member 14 is pulled rearward relative to the cylindrical tightening member 15, As shown in FIG. 2, the base 11a of the gripping member 11 is drawn into the cylindrical fastening member 15 while elastically deforming inward. Then, the diameter of the base 11a is reduced, and the two inclined pieces 11b and the two open / close pieces 11c are in an open state where they are separated from each other.
As shown in FIG. 3, when the traction separation member 14 is further pulled relatively rearward with respect to the cylindrical fastening member 15, the gripping member 11 is elastically deformed inward, and the inside of the cylindrical fastening member 15 is moved. Further, the inclined piece 11b comes into contact with the opening at the tip end of the tubular fastening member 15, and the open / close piece 11c and the claw 11d are brought into a closed state in which they approach each other.
[0032]
FIG. 4 shows an endoscope 20 used to perform a resection operation using the anchor remote guidance system.
As is well known, the endoscope 20 has an insertion portion 21 which is flexible and flexible and is inserted into the body, and has a distal end surface 22 provided with an air supply for sending air and cleaning water. A water supply nozzle (not shown), an illumination window (not shown) for illuminating the cutout and its surroundings, an observation window for observing the cutout where the objective lens and the image sensor are arranged immediately after, and an observation window for FIG. The outlet 23 of the forceps channel C shown in FIG. The forceps channel C is formed in the insertion portion 21, the entrance 24a is formed in the end face of the forceps port 24, and the exit 23 has a tapered shape whose diameter increases on the tip side.
[0033]
Next, the operation device 30 inserted into the forceps channel C of the endoscope 20 will be described with reference to FIG.
The insertion tube 31 is a flexible cylindrical member, and can be inserted into the forceps channel C from the entrance 24 a of the forceps port 24 of the endoscope 20, and its entire length is longer than the forceps channel C. Further, the inner diameter is such that the holding member 11 and the cylindrical fastening member 15 in the state of FIG. 1 can be inserted. Inside the insertion tube 31, a cylindrical insertion coil 32 that can move relatively to the insertion tube 31 is inserted. A small-diameter portion 33b of the regulating tube 33 composed of a large-diameter portion 33a and a small-diameter portion 33b is fitted to the tip of the insertion coil 32, and the small-diameter portion 33b is fixed to the tip of the insertion coil 32 by an adhesive, solder, brazing, or the like. It is fixed to the part.
[0034]
The outer diameter of the large diameter portion 33a is smaller than the inner diameter of the insertion tube 31, and is set substantially equal to the outer diameter of the insertion coil 32. Further, the inner diameter of the large-diameter portion 33a is larger than the inner diameter of the small-diameter portion 33b, and is set to be substantially the same as the outer shape of the tubular fastening member 15, and the connection between the inner surface of the large-diameter portion 33a and the inner surface of the small-diameter portion 33b is formed. An annular step 33a1 orthogonal to the axis of the regulating pipe 33 is formed (see FIG. 7 and the like).
[0035]
Inside the insertion coil 32 inserted into the forceps channel C, an operation wire 35 provided with a hook portion 34 at the tip is inserted so as to be relatively movable with respect to the insertion coil 32 and the regulating tube 33. The base of the hook portion 34 is fixed to the distal end of the operation wire 35 with an adhesive, solder, brazing, or the like.
The base ends of the insertion tube 31, the insertion coil 32, and the operation wire 35 are connected to an operation unit (not shown) of the operation device 30, and are relatively movable in the axial direction.
Further, the operation device 30 is configured by the insertion tube 31, the insertion coil 32, the restriction tube 33, the hook portion 34, the operation wire 35, and the operation portion described above.
[0036]
Next, the configuration of the magnetic anchor guiding device 40 that controls suction of the magnetic anchor 12 outside the body of the patient A will be described with reference to FIGS. 5 and 6.
A pair of XY stages (one-way moving mechanisms) 42, 42 are arranged on both sides of a bed 41 having a floor plate 41a on which the patient A is placed. The pair of XY stages 42 reciprocate linearly along the longitudinal direction of the bed 41 so that the longitudinal positions of the two 42 are always the same. Further, above the bed 41, a frame / rail composed of two rails 44 and 45 each having a substantially inverted U-shape in a front view and being parallel to each other in a plane orthogonal to the longitudinal direction of the bed 41 (in-plane moving mechanism). 43, and both ends of the frame / rail 43 are fixed to the left and right XY stages 42, respectively. A magnetic guide member 46 that controls the suction of the magnetic anchor 12 outside the body (applies a magnetic force to the magnetic anchor 12) is slidably mounted on the inner rail 44. The magnetic guide member 46 is attached to the left and right XY stages 42. It can move along the rail 45 between them. The magnetic guiding member 46 is formed by fixing an electromagnet 47 having a structure in which a coil is wound around an iron core on a base 48, and the electromagnet 47 is always facing the patient A (see FIG. 5). The magnetic guiding member 46 may be a combination of a permanent magnet and an electromagnet, or a combination of two or more permanent magnets and an electromagnet.
[0037]
A counter weight 49 for maintaining the weight balance of the entire frame / rail 43 is slidably mounted on the rail 45 outside the frame / rail 43. The position of the counterweight 49 changes according to the position of the magnetic guide member 46. For example, when the magnetic guiding member 46 is located on the front side of the patient A, the counterweight 49 is located on the back side of the patient A, and when the magnetic guiding member 46 is on the back side of the patient A, the counterweight 49 is The weight of the entire frame / rail 43 is balanced at the front side of the patient A.
The magnetic guide member 46, the XY stage 42, and the frame / rail 43 described above constitute the magnetic anchor guide device 40.
[0038]
Next, the procedure for excision of the lesion X using the anchor remote guidance system will be described.
Prior to performing the resection using the anchor remote guidance system, first, as shown in FIGS. 5 and 6, the patient A who has been subjected to local anesthesia is laid on the floor plate 41 a of the bed 41. At this time, by operating the XY stage 42, the longitudinal position of the bed 41 of the frame / rail 43 is set to substantially the same position as the head A1 of the patient A, and the magnetic guiding member 46 and the counterweight 49 are also moved to predetermined positions. In the place.
Next, the XY stage 42 is operated to arrange the frame / rail 43 on the front side of the patient A, and further, the magnetic guiding device 46 is moved along the frame / rail 43 to start the resection of the magnetic guiding member 46. It is positioned at the hour position (see FIG. 6).
[0039]
Next, a flexible overtube, not shown, is inserted into the body through the mouth of the patient A, and the distal end of the overtube is inserted into the organ B (object) (see FIGS. 8 to 13). Part (target part) X. Subsequently, the insertion section 21 of the endoscope 20 is inserted into the overtube, and the distal end of the insertion section 21 is protruded from the distal end of the overtube so as to approach the lesion X (not shown). As described above, when the distal end of the insertion portion 21 of the endoscope 20 is inserted into the organ B, an observation image in the organ B obtained from the observation window provided on the distal end surface 22 of the insertion portion 21 of the endoscope 20 Is displayed on a television monitor (not shown).
[0040]
Next, a tubular treatment tool (not shown) having an injection needle at the tip is inserted into the forceps channel C from the inlet 24a of the forceps port 24, and the injection needle is projected from the outlet 23 of the forceps channel C. Then, an injection needle is inserted into the submucosa B1 of the organ wall from the periphery of the lesion X to inject physiological saline or the like so that the lesion X is raised from the proper muscle layer B2 (see FIGS. 8 to 12). .
[0041]
Subsequently, the treatment tool is taken out from the forceps channel C, and the insertion tube 31 is inserted into the forceps channel C instead. As described above, since the insertion tube 31 is longer than the forceps channel C, when the insertion tube 31 is inserted into the forceps channel C, its proximal end protrudes from the forceps port 24 (not shown).
Next, outside the endoscope 20, the proximal end of the tubular fastening member 15 is fitted into the large-diameter portion 33a of the regulating tube 33 fixed to the distal end of the insertion coil 32, and the rear end face is formed into an annular stepped portion. 33a1. Further, the insertion coil 32 is inserted from the proximal end side of the insertion tube 31 into the inside thereof, and the operation wire 35 is inserted into the insertion coil 32, and the hook portion 34 fixed to the distal end portion is inserted into the endoscope 20. (Not shown). In this state, the hook portion 14c of the traction separation member 14 of the magnetic anchor device 10 is engaged with the hook portion 34, and the magnetic anchor device 10 and the operating device 30 are integrated.
[0042]
In this state, when the operation wire 35 is pulled to the proximal end side, as shown in FIG. 7, the gripping member 11, the traction connection member 14, and the mounting portion 12 c of the magnetic anchor 12 are pulled into the forceps channel C, and the magnetic anchor Since the operation wire 35 whose rear portion 12b is fitted to the outlet 23 of the forceps channel C is sufficiently longer than the insertion tube 31, the base end of the operation wire 35 is connected to the base end of the insertion tube 31 protruding from the forceps port 24. Projecting further rearward of the portion (not shown).
Further, since the tubular fastening member 15 is formed from a flexible material and the insertion coil 32 is bendable, even when the insertion portion 21 is bent, these members are connected to the forceps channel C. It can be inserted smoothly.
[0043]
After the magnetic anchor device 10 and the operating device 30 are set on the endoscope 20 as described above, the insertion tube 31 is moved forward, as shown in FIG. (Not shown). Then, the magnetic anchor 12 is pushed out from the forceps channel C.
Next, the insertion coil 32 is pressed forward to cause the gripping member 11 to protrude from the distal end of the insertion tube 31, bring the gripping member 11 close to the lesion X, and move the operation wire 35 relative to the endoscope 20. Pull backward. Then, the base 11a of the gripping member 11 is pulled into the cylindrical fastening member 15, and the gripping member 11 is in the open state shown in FIG.
[0044]
When the operating wire 35 is further pulled rearward, the base 11a of the gripping member 11 is further pulled rearward inside the tubular fastening member 15, and the inclined piece 11b comes into contact with the distal end opening of the tubular fastening member 15. Therefore, the opening / closing piece 11c of the gripping member 11 is closed, the two claws 11d penetrate the lesion X, and the lesion X is reliably gripped by the gripping member 11 (see FIG. 9).
[0045]
In this state, when the operation wire 35 is pulled backward with a strong force equal to or greater than the cutting force, the traction separation member 14 engaged with the hook portion 34 is cut at an intermediate portion thereof, and as a result, the magnetic anchor device 10 Is separated from the operation wire 35 (see FIG. 10).
[0046]
Subsequently, as shown in FIG. 11, when the magnetic anchor 12 is attracted to the upper side of FIG. 11 by increasing the magnetic field generated by the magnetic guiding member 46 disposed outside the patient A, the gripping member 11 is moved in the magnetic force direction ( 11 (upper in FIG. 11), the connecting cord 13 moves upward in FIG. 11 while tensioning the slit 15a, and the lesion X gripped by the gripping member 11 is also lifted by a sufficient distance in the same direction. .
At this time, even if blood bleeds from the lesion X and its surroundings, and the blood adheres to the magnetic anchor 12, the magnetic anchor 12 is colored green, which is most easily distinguished from red blood. The surgeon can clearly grasp the position of the magnetic anchor 12 through the television monitor. For this reason, even if blood adheres to the magnetic anchor 12, the operator can move the magnetic anchor 12 in a desired direction.
[0047]
As described above, when the lesion X is moved in a desired direction by a desired distance, a sufficiently large excised portion is formed at the boundary between the lesion X and normal tissue. , And the operation wire 35 are taken out of the endoscope 20, and as shown in FIG. 11, a dissecting tool such as a high-frequency knife 50 is inserted into the organ B using the forceps channel C of the endoscope 20 (not shown in FIG. 11). And the lesioned part X is excised together with the mucous membrane from one end side.
Then, when the lesion X is cut from one end to the opposite end, the entire lesion X is eventually completely cut (see FIG. 12).
During the cutting operation using the high-frequency knife 50, it is easier to confirm the position of the distal end 50a of the high-frequency knife 50 as the resection area expands.
[0048]
When the resection operation is completed as described above, the diseased part X separated from the normal tissue remains in a state of being held by the gripping member 11 (the magnetic anchor device 10), and thus the loss of the diseased part X is prevented.
In order to collect the excised lesion X, as shown in FIG. 12, the forceps channel C of the endoscope 20 is provided with a pair of openable and closable gripping pieces 61 at its distal end, and further, at its proximal end. The grasping forceps 60 provided with the operation unit (not shown) is inserted into the device. Then, by operating the operation unit, the gripping piece 61 is brought into close proximity to the towing separation member 14 in an open state, and then both the gripping pieces 61 are closed, and the towing separation member 14 is securely moved by the both gripping pieces 61. Hold it (see FIG. 12). Then, the endoscope 20 is removed from the body as it is, and the lesion X is taken out of the body together with the magnetic anchor device 10. Then, a procedure such as suturing or disinfecting the resected portion is performed.
[0049]
As described above, when the anchor remote guiding system according to the present embodiment is used, the magnetic anchor 12 is colored green so that it can be easily distinguished from blood visually, so that blood bleeding from the lesion X and its surroundings is obtained. Is attached to the magnetic anchor 12, the operator can clearly grasp the position of the magnetic anchor 12 through the television monitor. Therefore, the surgeon can move the magnetic anchor 12 in a desired direction.
[0050]
Furthermore, since the lesion X can be moved in the desired direction by a sufficient distance, a cut portion at the boundary between the lesion X and normal tissue can be easily and reliably secured in a sufficient size. Even if the lesion X is flat, a sufficiently large resection can be created, so that the lesion X can be easily resected.
[0051]
Further, since the diseased part X is lifted by the gripping member 11, a sufficient resection can be secured, and the already resected diseased part X can be prevented from dropping onto the proper muscle layer B2.
Further, since the grasping member 11 can be arranged at an arbitrary position, the view of the endoscope 20 is not obstructed by the excised lesion X.
[0052]
Further, as shown in FIG. 13, even if the connecting cord 13 is cut after the lesion X is cut off and the magnetic anchor 12 is separated from the traction separating member 14, the position of the magnetic anchor 12 is clearly grasped. Therefore, the magnetic anchor 61 can be grasped by the grasping forceps 61 and the magnetic anchor 61 can be easily collected outside the body.
[0053]
Next, a second embodiment of the present invention will be described with reference to FIG.
The same members as those in the first embodiment are denoted by the same reference numerals, and detailed description thereof is omitted.
[0054]
The remote anchor guidance system according to the present embodiment includes a gravity anchor device 70 (consisting of a gripping member 11, a gravity anchor 71, a connecting string 13, a traction separation member 14, and a tubular fastening member 15) and an operation device 30. It is.
[0055]
The outer shape of the gravity anchor 71 is the same as that of the magnetic anchor 12, and includes a front portion 71a, a rear portion 71b, a mounting portion 71c, and a concave portion (not shown in FIG. 14), and is entirely formed of a non-magnetic material. Specific examples of the non-magnetic material include gold, copper, aluminum, stainless steel (austenitic), brass, ceramic, glass, and the like. And the gravity anchor 71 of this embodiment is also colored green like the magnetic anchor 12.
[0056]
After the gravity anchor device 70 is inserted into the organ B while being attached to the endoscope 20 in the same manner as in the first embodiment, the gripping member 11 grips the lesion X.
Then, since the gravity anchor 71 moves in accordance with the gravity P, when the posture of the patient A is changed and the gravity anchor 71 is moved downward in the direction of gravity, the string portion 13 is tensioned, and the lesion held by the grip member 11 is gripped. The part Y moves downward in the direction of gravity. For this reason, a sufficiently large resection portion is formed at the boundary between the lesion portion X and the normal tissue, and the high-frequency knife 50 (not shown in FIG. 14) resects the lesion portion X.
[0057]
As described above, according to the anchor remote guiding system of the present embodiment, similarly to the first embodiment, the gravity anchor 71 is colored green, which is most easily distinguished from blood visually, so that the lesion X The operator can clearly grasp the position of the gravity anchor 71 through the television monitor even if blood bleeding from the blood and the surrounding area adheres to the gravity anchor 71, and the operator can move the gravity anchor 71 in a desired direction. it can.
Furthermore, in the present embodiment, the magnetic anchor guiding device 40, which is an expensive device that was required in the first embodiment, is not required, so that it is advantageous in cost as compared with the first embodiment.
[0058]
Although the present invention has been described with reference to the above embodiment, the present invention is not limited to the above embodiment, and can be improved or changed within the scope of the purpose of improvement or the concept of the present invention. For example, the surfaces of the magnetic anchor 12 and the gravity anchor 71 may be colored with other colors whose hues are in the range of 5 GY to 5 B in the Munsell hue circle, preferably in the range of 10 G to 10 GY. Even if it is colored in such a color, the surgeon can clearly grasp the positions of the magnetic anchor 12 and the gravity anchor 71 to which the blood bleeding from the lesion X and its surroundings adheres through the television monitor. Furthermore, the same color as the magnetic anchor 12 or the gravity anchor 71 may be colored on the surface of the connecting string 13 or the gripping member 11, so that even if blood adheres to the connecting string 13 or the gripping member 11. Since the positions of these members can be accurately grasped, the treatment operation can be performed more accurately.
[0059]
【The invention's effect】
As described above, according to the present invention, even if bleeding occurs from the target object and blood adheres to the anchor, the operator can accurately grasp the position of the anchor by viewing the endoscopic observation image. it can.
[Brief description of the drawings]
FIG. 1 is an overall view of a magnetic anchor device according to a first embodiment of the present invention.
FIG. 2 is an overall view of a magnetic anchor device in a state where a gripping member is opened.
FIG. 3 is an overall view of a magnetic anchor device in a state where a gripping member is closed.
FIG. 4 is an overall view of an endoscope.
FIG. 5 is a view of a bed on which a patient from which a lesion is to be resected is placed and a magnetic anchor guiding device as viewed from the patient's head side.
FIG. 6 is a side view of a bed on which a patient is placed and a magnetic anchor guiding device.
FIG. 7 is an enlarged vertical cross-sectional side view of the distal end portion of the endoscope, showing a state in which the operating device is inserted into the forceps channel in cooperation with the magnetic anchor device.
FIG. 8 is an enlarged vertical sectional side view showing a state immediately before a gripping member protruding from a distal end of the endoscope grips a lesion in an opened state.
FIG. 9 is an enlarged vertical cross-sectional side view showing a state in which a grasping member protruding from a distal end of the endoscope is closed and a lesion is grasped.
FIG. 10 is an enlarged vertical sectional side view showing a state in which the magnetic anchor device and the operating device are separated inside the endoscope.
FIG. 11 is an enlarged vertical sectional side view showing a state in which the lesion is lifted by using the magnetic anchor guiding device after the gripping member grips the lesion.
FIG. 12 is a diagram showing a state in which a magnetic anchor holding a lesion is gripped by gripping forceps.
FIG. 13 is a diagram showing a state in which a magnetic anchor that has been cut off from a gripping member by breaking a connecting string is gripped by gripping forceps.
FIG. 14 is an enlarged vertical sectional side view showing a state in which a lesion is moved downward in the direction of gravity using a gravity anchor according to the second embodiment of the present invention.
[Explanation of symbols]
Reference Signs List 10 magnetic anchor device 11 gripping member 11a base 11a1 insertion hole 11b inclined piece 11c opening / closing piece 11d claw section 12 magnetic anchor 12a front part 12b rear part 12c mounting part 12d recess 13 connecting string 14 traction separating member 14a insertion piece 14b retaining part 14c hook Part 15 Cylindrical fastening member 20 Endoscope 21 Insertion part 22 Tip surface 23 Forceps channel outlet 24 Forceps port 24a Inlet 30 Operating device 31 Insertion tube 32 Insertion coil 33 Restriction tube 33a Large diameter portion 33a1 Annular step 33b Small diameter portion 34 Hook 35 Operation wire 40 Magnetic anchor guiding device 41 Bed 41a Floor plate 42 XY stage (one-way moving mechanism)
43 frame / rail (moving mechanism within one plane)
44 45 Rail 46 Magnetic guide member 47 Electromagnet 48 Base 49 Counterweight 50 High frequency knife 50a Tip 60 Grasping forceps 61 Grabbing piece 70 Gravity anchor device 71 Gravity anchor 71a Front 71b Back 71c Attachment 71d Depression A Patient (object)
A1 head B organ B1 submucosa B2 proper muscle layer C forceps channel P gravity X lesion (target site)

Claims (19)

A gripping member that grips a target portion inside the target object,
A magnetic anchor made of a magnetic material connected to the gripping member,
A magnetic anchor guide device that is disposed outside the object and generates a magnetic field to power the magnetic anchor,
In the endoscope anchor remote guiding system for raising power of the target portion gripped by the gripping member by giving power to the magnetic anchor by a magnetic field generated by the magnetic anchor guiding device,
An anchor remote guiding system for an endoscope, wherein the surface of the magnetic anchor is colored in a Munsell hue circle in any color in the range of 5GY to 5B. The anchor remote guidance system for an endoscope according to claim 1,
An anchor remote guidance system for an endoscope, wherein the color of the surface of the magnetic anchor is any color whose hue is in the range of 10 G to 10 GY in a Munsell hue circle. 3. An endoscope anchor remote guiding system according to claim 1, wherein said magnetic anchor and said gripping member are connected by a flexible connecting string. 4. The remote guiding system for an endoscope anchor according to claim 3, wherein the connecting string is colored in any one of colors ranging from 5GY to 5B in a Munsell hue circle. The endoscope anchor remote guidance system according to any one of claims 1 to 4,
The magnetic anchor guiding device,
A magnetic induction member that generates a magnetic force by the generated magnetic field and moves the magnetic anchor in a predetermined direction by the magnetic force;
An in-plane moving mechanism for moving the magnetic guide member along a U-shaped frame member arranged in a specific plane;
A one-way moving mechanism for relatively moving the U-shaped frame member in a direction perpendicular to the one plane,
A remote guidance system for an endoscope having an anchor. A gripping member that grips a target portion inside the target object,
A gravitational anchor made of a non-magnetic material connected to the gripping member and moving according to gravity,
By moving the gravity anchor in the direction of gravity, the endoscope anchor remote guidance system for moving the target portion gripped by the gripping member in the direction of gravity,
An anchor remote guidance system for an endoscope, wherein a surface of the gravity anchor is colored in a Munsell hue circle in any one of colors ranging from 5GY to 5B. The anchor remote guidance system for an endoscope according to claim 6,
An anchor remote guidance system for an endoscope, wherein the color of the surface of the gravity anchor is any color whose hue is in the range of 10 G to 10 GY in a Munsell hue circle. The remote guidance system for an endoscope according to claim 6 or 7, wherein the gravity anchor and the gripping member are connected by a flexible connection string. 9. The remote guidance system for an endoscope anchor according to claim 8, wherein the connecting string is colored in any one of colors ranging from 5GY to 5B in a Munsell hue circle. An endoscope anchor remote guidance system according to any one of claims 1 to 9,
The gripping member,
An endoscope anchor remote guide comprising: a plurality of openable and closable pieces; and a claw formed at a distal end of the piece, which grips the target portion when the openable piece is in a closed state. system. Disposing a connector between a magnetic anchor, which is made of a magnetic material and has a hue of any one of colors ranging from 5 GY to 5 B in the Munsell hue circle and whose surface is colored, and a gripping member, inside the object; ,
A gripping step of gripping a target portion inside the object by the gripping member, and generating a magnetic field from a magnetic anchor guiding device arranged outside the object, moving the magnetic anchor by the magnetic field, Lifting the target site gripped by the member in a predetermined direction,
A treatment method using an endoscope using an anchor remote guidance system, comprising: A treatment method using an endoscope using the anchor remote guidance system according to claim 11,
A treatment method using an endoscope using an anchor remote guidance system in which a color colored on the surface of the magnetic anchor is colored to any one of colors ranging from 10 G to 10 GY in a Munsell hue circle. A treatment method using an endoscope using the anchor remote guidance system according to claim 11 or 12,
A treatment method by an endoscope using an anchor remote guiding system in which the gripping member and the magnetic anchor are connected by a flexible connecting string. An endoscopic treatment method using the anchor remote guidance system according to claim 13,
A method of treating an endoscope using an anchor remote guidance system in which the connecting string is colored in any color having a hue ranging from 5 GY to 10 B in a Munsell hue circle. Disposing a gravitational anchor whose surface is colored in any color having a Munsell hue circle in the range of 5GY to 5B and made of a non-magnetic material, and a connector of a gripping member inside the object; ,
A gripping step of gripping a target portion inside the target object by the gripping member, and moving the gravity anchor according to gravity, and moving the target portion gripped by the gripping member in the direction of gravity;
A treatment method using an endoscope using an anchor remote guidance system, comprising: An endoscopic treatment method using the anchor remote guidance system according to claim 15,
A treatment method using an endoscope using an anchor remote guidance system in which a color colored on the surface of the gravity anchor is any color whose hue is in a range of 10 G to 10 GY in a Munsell hue circle. An endoscopic treatment method using the anchor remote guidance system according to claim 15 or 16,
A treatment method using an endoscope using an anchor remote guidance system in which the gripping member and the gravity anchor are connected by a flexible connection string. A treatment method using an endoscope using the anchor remote guidance system according to claim 17,
A method for treating an endoscope using an anchor remote guiding system in which the connecting string is colored in any color whose hue ranges from 5 GY to 5 B in a Munsell hue circle. An endoscopic treatment method using the anchor remote guidance system according to any one of claims 11 to 18,
The gripping member includes a plurality of openable and closable pieces that can be opened and closed, and a claw formed at a tip end of the openable and closable pieces,
The gripping step includes:
A step of closing the open / close piece and gripping the target site with the claw section, the treatment method using an endoscope using an anchor remote guidance system.

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